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Journal of the American Academy of... Feb 2022Although hidradenitis suppurativa (HS) shares some transcriptomic and cellular infiltrate features with psoriasis, their skin proteome remains unknown.
BACKGROUND
Although hidradenitis suppurativa (HS) shares some transcriptomic and cellular infiltrate features with psoriasis, their skin proteome remains unknown.
OBJECTIVE
To define and compare inflammatory protein biomarkers of HS and psoriasis skin.
METHODS
We assessed 92 inflammatory biomarkers in HS (n = 13), psoriasis (n = 11), and control skin (n = 11) using Olink high-throughput proteomics. We also correlated HS skin and blood biomarkers using proteomics and RNA sequencing.
RESULTS
We identified 57 differentially expressed proteins (DEPs) in lesional psoriasis and 64 DEPs in lesional HS skin, compared to healthy controls. Both HS and psoriasis lesional skin demonstrated a significant upregulation of T helper 1 and T helper 17 proteins. Healthy-appearing perilesional HS skin had 63 DEPs compared to healthy controls. Nonlesional HS and psoriasis skin had 24 and 7 DEPs, respectively, compared to healthy controls. Tumor necrosis factor and 8 other proteins were significantly correlated with clinical severity in perilesional HS skin (2 cm from a nodule).
LIMITATIONS
Inclusion of only moderate-to-severe patients and the cohort size.
CONCLUSION
HS has a greater inflammatory profile and is more diffusely distributed compared with psoriasis. Proteins correlated with disease severity are potential disease mediators. Perilesional skin is comparably inflamed to lesional skin, suggesting the need to treat beyond skin nodules.
Topics: Biomarkers; Hidradenitis Suppurativa; Humans; Proteome; Psoriasis; Skin
PubMed: 34339761
DOI: 10.1016/j.jaad.2021.07.035 -
The American Journal of Dermatopathology Jan 2020
Review
Topics: Aged, 80 and over; Biopsy, Needle; Drug Therapy, Combination; Histiocytosis, Sinus; Humans; Immunohistochemistry; Male; Methotrexate; Prednisone; Rare Diseases; Severity of Illness Index; Skin; Treatment Outcome
PubMed: 31880636
DOI: 10.1097/DAD.0000000000001293 -
Clinical and Experimental Dermatology Jan 2017
Topics: Angiolipoma; Biopsy; Diagnosis, Differential; Female; Humans; Middle Aged; Pain; Skin; Skin Neoplasms
PubMed: 27935631
DOI: 10.1111/ced.12897 -
Der Hautarzt; Zeitschrift Fur... Jul 2016Panniculitides are diseases of the subcutaneous tissue with heterogeneous etiology. They may develop consequent to infections, as a reaction to drugs, after thermal... (Review)
Review
Panniculitides are diseases of the subcutaneous tissue with heterogeneous etiology. They may develop consequent to infections, as a reaction to drugs, after thermal injury, as part of autoimmune diseases, in metabolic disorders or due to infectious organisms. The clinical presentation with subcutaneous nodules is often nonspecific. Moreover, the differentiation from vasculitides of medium-sized vessels can be clinically challenging. Microscopic examination of biopsy specimens is of high importance in the differential diagnosis of panniculitides. Histopathologically, panniculitides can be classified according to the predominantly infiltrated area in septal and lobular panniculitides and they can be separated from vasculitides of medium-sized vessels. Diagnostic difficulties arise from inadequate biopsy specimens and from lack of clinicopathological correlation. This article summarizes diagnostic criteria of frequent and clinically important panniculitides.
Topics: Dermoscopy; Diagnosis, Differential; Humans; Microscopy; Panniculitis; Skin; Vasculitis
PubMed: 27226115
DOI: 10.1007/s00105-016-3794-2 -
International Journal of Molecular... May 2024Chronic pruritus that lasts for over 6 weeks can present in various forms, like papules, nodules, and plaque types, with prurigo nodularis (PN) being the most prevalent.... (Review)
Review
Chronic pruritus that lasts for over 6 weeks can present in various forms, like papules, nodules, and plaque types, with prurigo nodularis (PN) being the most prevalent. The pathogenesis of PN involves the dysregulation of immune cell-neural circuits and is associated with peripheral neuropathies, possibly due to chronic scratching. PN is a persistent and challenging condition, involving complex interactions among the skin, immune system, and nervous system. Lesional skin in PN exhibits the infiltration of diverse immune cells like T cells, eosinophils, macrophages, and mast cells, leading to the release of inflammatory cytokines and itch-inducing substances. Activated sensory nerve fibers aggravate pruritus by releasing neurotransmitters, perpetuating a vicious cycle of itching and scratching. Traditional treatments often fail, but recent advancements in understanding the inflammatory and itch transmission mechanisms of PN have paved the way for innovative therapeutic approaches, which are explored in this review.
Topics: Humans; Prurigo; Pruritus; Animals; Cytokines; Skin
PubMed: 38791201
DOI: 10.3390/ijms25105164 -
Der Hautarzt; Zeitschrift Fur... Nov 2021Rheumatoid arthritis is one of the most common autoimmune disorders. In addition to chronic arthritis, rheumatoid arthritis may present a variety of extra-articular... (Review)
Review
BACKGROUND
Rheumatoid arthritis is one of the most common autoimmune disorders. In addition to chronic arthritis, rheumatoid arthritis may present a variety of extra-articular manifestations, most commonly of the skin.
OBJECTIVES
Cutaneous manifestations associated with rheumatoid arthritis can be diverse, both specific and nonspecific. Which dermatoses should lead you to the diagnosis of an underlying rheumatoid arthritis?
METHODS
Evaluation of exemplary overviews, case presentations and relevant textbook articles.
RESULTS
Rheumatoid arthritis presents various specific and nonspecific skin manifestations. Besides visual diagnosis like classic rheumatoid nodules a histopathologic correlation or an interdisciplinary approach is often needed, such as for diagnosis of pyoderma gangrenosum.
CONCLUSIONS
The early detection and correct classification of cutaneous manifestations associated with rheumatoid arthritis can be groundbreaking for a successful therapy and a consequently better prognosis for patients with rheumatoid arthritis. Therefore dermatologists bear responsibility in the patient-centered care.
Topics: Arthritis, Rheumatoid; Humans; Pyoderma Gangrenosum; Rheumatoid Nodule; Skin
PubMed: 34609535
DOI: 10.1007/s00105-021-04893-3 -
The American Journal of Dermatopathology Mar 2022Primary dermal melanoma (PDM) is defined as a primary melanoma tumor confined to the dermis, subcutis, or both, without epidermal involvement. The significant overlap of...
Primary dermal melanoma (PDM) is defined as a primary melanoma tumor confined to the dermis, subcutis, or both, without epidermal involvement. The significant overlap of histopathological features in PDM and cutaneous metastatic melanoma makes diagnostic accuracy of PDM challenging. We present a case of a 48-year-old man with a nontender 1.5 × 1.5 cm subcutaneous nodule on the left leg, which had been present for years. Biopsy revealed a dermal tumor with melanocytic differentiation noted to be positive for SOX-10. Additional pathology findings included a high Ki-67 proliferation index and a loss of p16 expression. Pathology reports were consistent with primary tumor stage 4a, and the patient was referred to surgical oncology where examination and workup demonstrated no evidence of the residual lesion representing a metastasis from a primary site. As PDM is histologically indistinguishable from melanoma metastasis to the skin, clues including a history of an evolving subepidermal nodule and exclusion of previous or concurrent melanomas can assist in its accurate diagnosis. Currently, a consensus on the criteria, staging, and management of PDM does not exist. Poorly defined diagnostic criteria and general lack of awareness of PDM result in high rates of incorrect and late-stage diagnoses. This case report highlights the importance of physician familiarity with PDM to ensure accurate recognition, evidence-based management, and improved patient outcomes.
Topics: Dermis; Humans; Male; Melanoma; Middle Aged; Subcutaneous Tissue
PubMed: 34726186
DOI: 10.1097/DAD.0000000000002099 -
Cutis Sep 2023
Topics: Humans; Infant; Mouth Mucosa; Skin; Skin Abnormalities
PubMed: 37903403
DOI: 10.12788/cutis.0851 -
Archives of Pathology & Laboratory... Aug 2019Cutaneous metastases from a distant malignancy are a diagnostic challenge for pathologists. Secondary involvement of the skin by a metastatic process portends a much... (Review)
Review
CONTEXT.—
Cutaneous metastases from a distant malignancy are a diagnostic challenge for pathologists. Secondary involvement of the skin by a metastatic process portends a much worse clinical prognosis than any primary cutaneous malignant mimickers. Immunohistochemical staining methods continue to evolve and are of paramount importance in diagnosis.
OBJECTIVE.—
To review the clinical, histopathologic, and immunohistochemical staining patterns for commonly encountered entities and discuss potential pitfalls in diagnosis. A practical guide useful in approaching cutaneous metastases of unknown primary is outlined.
DATA SOURCES.—
An extensive search and review of literature in PubMed was performed, processed, and condensed.
CONCLUSIONS.—
Cutaneous metastases have broad histopathologic patterns. They are nearly always dermal based, with an overall foreign appearance. They can be single papules/nodules or multiple in number, mimicking an inflammatory or infectious process. Ultimately, immunohistochemistry remains an essential diagnostic tool, and clinical correlation is paramount in the workup of these entities.
Topics: Biomarkers, Tumor; Diagnosis, Differential; Humans; Immunohistochemistry; Neoplasms, Unknown Primary; Pathology, Clinical; Practice Guidelines as Topic; Skin; Skin Neoplasms
PubMed: 30605024
DOI: 10.5858/arpa.2018-0051-RA -
Anais Brasileiros de Dermatologia Mar 2018Myeloid leukemia cutis is the terminology used for cutaneous manifestations of myeloid leukemia.
BACKGROUND
Myeloid leukemia cutis is the terminology used for cutaneous manifestations of myeloid leukemia.
OBJECTIVE
The purpose of this study was to study the clinical, histopathological and immunohistochemical features of myeloid leukemia cutis.
METHODS
This was a retrospective study of clinical and pathological features of 10 patients with myeloid leukemia cutis.
RESULTS
One patient developed skin lesions before the onset of leukemia, seven patients developed skin infiltration within 4-72 months after the onset of leukemia, and two patients developed skin lesions and systemic leukemia simultaneously. Of these patients, five presented with generalized papules or nodules, and five with localized masses. The biopsy of skin lesions showed a large number of tumor cells within the dermis and subcutaneous fat layer. Immunohistochemical analysis showed strong reactivity to myeloperoxidase (MPO), CD15, CD43 and CD45 (LCA) in most cases. NPM1 (nucleophosmin I) and FLT3-ITD (Fms-like tyrosine kinase 3-internal tandem duplication) mutations were identified in one case. Five patients with acute myelogenous leukemia and one patient with chronic myelomonocytic leukemia died within two months to one year after the onset of skin lesions.
STUDY LIMITATIONS
This was a retrospective and small sample study.
CONCLUSIONS
In patients with myelogenous leukemia, skin infiltration usually occurs after, but occasionally before, the appearance of hemogram and myelogram abnormalities, and the presence of skin infiltration is often associated with a poor prognosis and short survival time. myeloid leukemia cutis often presents as generalized or localized nodules or masses with characteristic pathological and histochemical findings.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Biopsy; Female; Humans; Immunohistochemistry; Leukemia, Myeloid; Leukemic Infiltration; Male; Middle Aged; Nucleophosmin; Prognosis; Retrospective Studies; Sex Factors; Skin; Time Factors
PubMed: 29723350
DOI: 10.1590/abd1806-4841.20186327