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Journal of Personalized Medicine Oct 2023Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder characterized by inflammatory arthritis and periarticular structural damage. Available evidence... (Review)
Review
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder characterized by inflammatory arthritis and periarticular structural damage. Available evidence suggests that RA results from complex interactions between genetic susceptibility (e.g., HLA-DRB1), environmental factors (e.g., smoking), and immune dysregulation. Alongside joint-related symptoms, individuals with RA may also experience a wide array of skin issues, including the development of nodules, neutrophilic dermatoses, vasculitis, and vasculopathy. Treatment strategies for these manifestations vary but routinely involve corticosteroids, disease-modifying anti-rheumatic drugs, and biologics, with individualized approaches guided by disease severity. In this review, we provide comprehensive insights into the skin-related issues associated with RA, outlining their clinical characteristics and histopathological findings. Our aim is to facilitate early diagnosis and personalized treatment to improve the quality of life of affected individuals.
PubMed: 37888090
DOI: 10.3390/jpm13101479 -
Pathogens (Basel, Switzerland) Jul 2023Tuberculosis is an ancient disease that humanity struggled with for centuries and continues to struggle with. The bacteria often infects the lungs through respiratory... (Review)
Review
Tuberculosis is an ancient disease that humanity struggled with for centuries and continues to struggle with. The bacteria often infects the lungs through respiratory transmission and manifests itself through various symptoms, including cutaneous infections. Cutaneous tuberculosis (CTB) comprises about 1% to 1.5% of all extrapulmonary manifestations and is often accompanied by polymorphous lesions, including papules, nodules, plaques, ulcers, gummas, and verrucous lesions. CTB is most commonly observed in low-income, HIV, and immunosuppressed populations, similar to intrapulmonary manifestations. The main pathogen for CTB is but less commonly with and BCG vaccine, and the modes of transmission are largely classified into exogenous and endogenous CTB. Current treatment options for CTB include oral therapy of antibiotic medications such as rifampicin, streptomycin, ethambutol, isoniazid, and pyrazinamide, which is occasionally combined with surgical intervention.
PubMed: 37513768
DOI: 10.3390/pathogens12070920 -
MedRxiv : the Preprint Server For... Sep 2023Prurigo nodularis (PN) is a chronic inflammatory skin disease that disproportionately affects African Americans and is characterized by pruritic skin nodules of unknown...
Prurigo nodularis (PN) is a chronic inflammatory skin disease that disproportionately affects African Americans and is characterized by pruritic skin nodules of unknown etiology. Little is known about genetic alterations in PN pathogenesis, especially relating to somatic events which are often implicated in inflammatory conditions. We thus performed whole-exome sequencing on 54 lesional and nonlesional skin biopsies from 17 PN patients and 10 atopic dermatitis (AD) patients for comparison. Somatic mutational analysis revealed that PN lesional skin harbors pervasive somatic mutations in fibrotic, neurotropic, and cancer-associated genes. Nonsynonymous mutations were most frequent in and the Notch signaling pathway, a regulator of cellular proliferation and tissue fibrosis, and mutations were absent in AD. Somatic copy-number analysis, combined with expression data, showed that recurrently deleted and downregulated genes in PN lesional skin are associated with axonal guidance and extension. Follow-up immunofluorescence validation demonstrated increased expression in PN lesional skin fibroblasts and increased Notch signaling in PN lesional dermis. Finally, multi-center data revealed a significantly increased risk of -associated diseases in PN patients. In characterizing the somatic landscape of PN, we uncover novel insights into its pathophysiology and identify a role for dysregulated Notch signaling in PN.
PubMed: 37808834
DOI: 10.1101/2023.09.25.23295810 -
Ugeskrift For Laeger Feb 2024Sister Mary Joseph nodule (SMJN) is a rare clinical finding in patients with metastatic adenocarcinoma. This is a case report of a 69-year-old man, who presented with a...
Sister Mary Joseph nodule (SMJN) is a rare clinical finding in patients with metastatic adenocarcinoma. This is a case report of a 69-year-old man, who presented with a cutaneous element by his umbilicus at his GP. He was referred to a dermatologist, then a plastic surgeon. The element was a metastasis from adenocarcinoma originating from his caecum. It is important for doctors to know of SMJN as a rare presentation of metastatic cancer, and to clinically examine the patient for an abdominal starting point, when presented with a cutaneous tumour at the position of the umbilicus.
Topics: Male; Humans; Aged; Adenocarcinoma; Skin Neoplasms; Surgeons; Umbilicus
PubMed: 38445337
DOI: 10.61409/V07230477 -
Microorganisms Jul 2023Skin and soft tissue infections caused by non-tuberculous mycobacteria are occurring more frequently in recent years. However, chronic skin and soft tissue lesions... (Review)
Review
Skin and soft tissue infections caused by non-tuberculous mycobacteria are occurring more frequently in recent years. However, chronic skin and soft tissue lesions present a challenge for clinicians, as the diagnostic work-up and definitive diagnosis require knowledge and available laboratory resources. We present here the case of a 66-year-old male patient who presented with painful abscess-like nodules on his right hand and forearm, which worsened after treatment with an anti-TNF-a agent. The fluid specimen taken from the lesion was positive for mycobacteria according to the acid-fast stain. was identified, first by next-generation sequencing and finally grown on culture, after eight weeks. Acknowledging the complexity of diagnosing and managing infections by non-tuberculous mycobacteria, and especially , we provide a review of the current epidemiology, clinical characteristics, diagnosis and management of infection.
PubMed: 37512971
DOI: 10.3390/microorganisms11071799 -
Indian Dermatology Online Journal 2023
PubMed: 37727565
DOI: 10.4103/idoj.idoj_631_22 -
Clinical Case Reports Feb 2024Scabies is a highly infectious parasitic skin disease, The most common lesions are solid and 2-3 mm in diameter (papules). Very few cases will develop into nodular...
Scabies is a highly infectious parasitic skin disease, The most common lesions are solid and 2-3 mm in diameter (papules). Very few cases will develop into nodular scabies, and microscopy is frequently negative in patients with clinically diagnosed nodular scabies. The accuracy of microscopy depends on the expertise of the operator, particularly in finding burrows and extracting the relevant material.
PubMed: 38385053
DOI: 10.1002/ccr3.8542 -
Clinics in Geriatric Medicine Feb 2024Paraneoplastic syndromes include a variety of cutaneous presentations that have an associated internal malignancy. Some syndromes have a strong correlation to specific... (Review)
Review
Paraneoplastic syndromes include a variety of cutaneous presentations that have an associated internal malignancy. Some syndromes have a strong correlation to specific internal malignancies, whereas others are associated with a multitude of tumors. There are many cutaneous manifestations that suggest hematologic disorders, which will be reviewed in detail. Cutaneous metastases are commonly from breast and lung cancers and can present as nodules, vascular lesions, eczematous dermatitis, or inflammatory lesions. The most common histologic presentation of cutaneous metastasis is that of a dermal-based or subcutaneous-based nodule with sparing of the epidermis. Determination of origin of tumor requires immunohistochemistry and clinical correlation.
Topics: Humans; Skin Diseases; Skin Neoplasms; Paraneoplastic Syndromes; Lung Neoplasms
PubMed: 38000859
DOI: 10.1016/j.cger.2023.09.005 -
Nutrients Aug 2023Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by the appearance of painful inflamed nodules, abscesses, and pus-draining sinus tracts in... (Review)
Review
Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by the appearance of painful inflamed nodules, abscesses, and pus-draining sinus tracts in the intertriginous skin of the groins, buttocks, and perianal and axillary regions. Despite its high prevalence of ~0.4-1%, therapeutic options for HS are still limited. Over the past 10 years, it has become clear that HS is a systemic disease, associated with various comorbidities, including metabolic syndrome (MetS) and its sequelae. Accordingly, the life expectancy of HS patients is significantly reduced. MetS, in particular, obesity, can support sustained inflammation and thereby exacerbate skin manifestations and the chronification of HS. However, MetS actually lacks necessary attention in HS therapy, underlining the high medical need for novel therapeutic options. This review directs attention towards the relevance of MetS in HS and evaluates the potential of phytomedical drug candidates to alleviate its components. It starts by describing key facts about HS, the specifics of metabolic alterations in HS patients, and mechanisms by which obesity may exacerbate HS skin alterations. Then, the results from the preclinical studies with phytochemicals on MetS parameters are evaluated and the outcomes of respective randomized controlled clinical trials in healthy people and patients without HS are presented.
Topics: Humans; Hidradenitis Suppurativa; Metabolic Syndrome; Skin; Obesity; Inflammation; Phytochemicals
PubMed: 37686829
DOI: 10.3390/nu15173797 -
Anais Brasileiros de Dermatologia Mar 2024Prurigo is a reactive, hyperplastic skin condition characterized by pruritic papules, plaques, and/or nodules. The temporal classification includes acute/subacute and... (Review)
Review
Prurigo is a reactive, hyperplastic skin condition characterized by pruritic papules, plaques, and/or nodules. The temporal classification includes acute/subacute and chronic disease (≥ 6 weeks), with different clinical variants, synonymies, and underlying etiological factors. The immunology of chronic prurigo shows similarities with atopic dermatitis due to the involvement of IL-4 and IL-13, IL-22, and IL-31. Treatment includes antihistamines, topical steroids, dupilumab, and JAK inhibitors. Several conditions manifest clinically as prurigo-like lesions, and the correct clinical diagnosis must precede correct treatment. Furthermore, chronic prurigos represent a recalcitrant and distressing dermatosis, and at least 50% of these patients have atopic diathesis, the treatment of which may induce adverse effects, especially in the elderly. The quality of life is significantly compromised, and topical treatments are often unable to control symptoms and skin lesions. Systemic immunosuppressants, immunobiologicals, and JAK inhibitors, despite the cost and potential adverse effects, may be necessary to achieve clinical improvement and quality of life. This manuscript reviews the main types of prurigo, associated diseases, their immunological bases, diagnosis, and treatment.
PubMed: 38493053
DOI: 10.1016/j.abd.2023.11.003