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Indian Journal of Dermatology 2024Pityriasis Rosea (PR) is a common, yet enigmatic, dermatological condition characterized by a distinctive clinical presentation. Despite its prevalence, the aetiology...
BACKGROUND
Pityriasis Rosea (PR) is a common, yet enigmatic, dermatological condition characterized by a distinctive clinical presentation. Despite its prevalence, the aetiology and pathogenesis of PR remain elusive.
AIMS
To study the epidemiological and clinical aspects of patients with PR. To study dermoscopic findings and carry out histopathological correlation.
METHODS
A cross-sectional study of 50 patients was conducted. A detailed clinical history was taken and an examination was done followed by a dermoscopy. Quantitative data like age and duration of disease are presented with the help of standard deviation. Qualitative risk factors, like gender, age groups, symptomatology, site of lesion, findings or cutaneous examination, dermoscopy findings, and histopathology findings, are presented with the help of frequency and percentages.
RESULTS
PR shows male preponderance and mean age of occurrence being 30.8 ± 15.7 years. Forty per cent of patients had an atypical clinical presentation. The most frequently seen dermoscopy findings were diffuse red background (58%), peripheral collarette scale (62%), and peripheral dotted vessels (50%). On histopathology, the most common findings were spongiosis (44%), parakeratosis (38%), irregular acanthosis (34%), perivascular lymphocytic infiltrate (56%), and red blood cell extravasation (36%).
LIMITATIONS
Sample size was less due to COVID. As this was a corss-sectional study follow up of patients could not be done.
CONCLUSION
While the diagnosis of PR is clinical, it is difficult in atypical cases where dermoscopy comes to the aid. It also helps identify the age of lesions, thus helping decide the treatment strategy for patients. Biopsy remains the gold standard in ruling out other differentials of PR.
PubMed: 38841213
DOI: 10.4103/ijd.ijd_1071_23 -
Frontiers in Immunology 2024Psoriasis is a chronic inflammatory disease affecting skin and joints characterized by a chronically altered immune and inflammatory response. Several factors occur from... (Review)
Review
Psoriasis is a chronic inflammatory disease affecting skin and joints characterized by a chronically altered immune and inflammatory response. Several factors occur from the onset to the development of this disease due to different types of cells spatially and temporally localized in the affected area, such as, keratinocytes, macrophages, neutrophils and T helper lymphocytes. This scenario leads to the chronic release of high levels of inflammatory mediators (, IL-17, IL-23, IL-22, TNF-α, S100 proteins, Defensins) and lastly parakeratosis and thickening of the stratum spinosum. Extracellular vesicles (EVs) are small double membraned biological nanoparticles that are secreted by all cell types and classified, based on dimension and biogenesis, into exosomes, microvesicles and apoptotic bodies. Their role as vessels for long range molecular signals renders them key elements in the pathogenesis of psoriasis, as well as innovative platforms for potential biomarker discovery and delivery of fine-tuned anti-inflammatory therapies. In this review, the role of EVs in the pathogenesis of psoriasis and the modulation of cellular microenvironment has been summarized. The biotechnological implementation of EVs for therapy and research for new biomarkers has been also discussed.
Topics: Humans; Psoriasis; Extracellular Vesicles; Biomarkers; Animals; Skin; Cellular Microenvironment
PubMed: 38827737
DOI: 10.3389/fimmu.2024.1360618 -
Indian Journal of Pathology &... Mar 2024Darier disease (DD) is a rare genodermatosis. Literature on this topic is overwhelmingly dominated by case reports with rare clinical presentations, which have mentioned...
Darier disease (DD) is a rare genodermatosis. Literature on this topic is overwhelmingly dominated by case reports with rare clinical presentations, which have mentioned the histopathologic features briefly. The aim of this study was to document the histopathology of DD. Skin biopsies diagnosed as Darier disease based on clinicopathologic correlation over 12 years were reviewed for various epidermal and dermal features. There were 16 patients included, who most commonly presented in the third decade, with slight female predilection. The most common clinical presentation was hyperpigmented, hyperkeratotic, papules and plaques (91%), with 69% affecting the trunk. In addition to the classic suprabasal acantholytic clefts, we noted some unusual features: absence of parakeratosis (19%), a cornoid lamella-like pattern (62%), follicular acantholysis (13%) and multiple foci of involvement within a single biopsy (63%). Features such as the presence of dyskeratotic cells and minimal dermal lymphocytic infiltrates were concordant with previous literature. The limitation of this study was the small sample size. To conclude, pathologists must be aware of the variations in histopathology of Darier's disease, especially when challenged with atypical clinical presentations. The Darier-like pattern is met within several acantholytic diseases, and clinicopathologic correlation has the last word in arriving at a diagnosis.
PubMed: 38563701
DOI: 10.4103/ijpm.ijpm_610_23 -
Porcine Health Management Feb 2024The complex aetiology of gastric lesions in pigs remains largely unknown and effective preventive measures and pharmaceutical treatment of the disease have not been...
BACKGROUND
The complex aetiology of gastric lesions in pigs remains largely unknown and effective preventive measures and pharmaceutical treatment of the disease have not been developed yet. Regardless of the fact that the overwhelming majority of previous research works dealing with gastric ulceration in pigs focused on the role of the nutritional determinants, including chemical composition of feeds, cereal type, finely ground pelleted diets, and feed additives, conclusions presented therein remain highly ambiguous. Thus, the purpose of this study was to evaluate the impact of the disease on production performance, and investigate the influence of selected non-dietary risk factors on the prevalence of gastric alterations in finishing pigs reared under conditions of 11 modern farms located in Poland.
RESULTS
A total number of 26,043 finishing pigs was examined. 15,228 (58.47%) had gastric ulcers. Intact stomachs were detected in 6176 animals (23.71%). Parakeratosis and erosion were observed in 2551 (9.80%) and 2088 (8.02%), respectively. Among eight continuous variables two were found to be significantly associated with prevalence of the gastric ulcer: the growing number of animals in the herd, which was negatively correlated (P = 0.002; ρ = -0.37), and the growing average entry weight of animals transported to the finisher farm (P = 0.047; ρ = 0.24), which increased the risk of gastric ulcers prevalence. Among 12 nominal variables, problems with the quality of farm management (P = 0.041), and usage of straw as a bedding material (P = 0.002) were identified as determinants significantly associated with occurrence of the analysed health problem.
CONCLUSIONS
Among 20 non-nutritional variables analysed in our study only few factors were found to be associated with the prevalence of the disease. The impact of broadly understood management issues on gastric health in finishing pigs deserves further research.
PubMed: 38409105
DOI: 10.1186/s40813-024-00362-0 -
International Journal of Molecular... Dec 2023The epidermis serves many vital roles, including protecting the body from external influences and healing eventual injuries. It is maintained by an incredibly complex... (Review)
Review
The epidermis serves many vital roles, including protecting the body from external influences and healing eventual injuries. It is maintained by an incredibly complex and perfectly coordinated keratinization process. In this process, desquamation is essential for the differentiation of epidermal basal progenitor cells into enucleated corneocytes, which subsequently desquamate through programmed death. Numerous factors control keratinocyte differentiation: epidermal growth factor, transforming growth factor-α, keratinocyte growth factor, interleukins IL-1-β and IL-6, elevated vitamin A levels, and changes in Ca concentration. The backbone of the keratinocyte transformation process from mitotically active basal cells into fully differentiated, enucleated corneocytes is the expression of specific proteins and the creation of a Ca and pH gradient at precise locations within the epidermis. Skin keratinization disorders (histologically characterized predominantly by dyskeratosis, parakeratosis, and hyperkeratosis) may be categorized into three groups: defects in the α-helical rod pattern, defects outside the α-helical rod domain, and disorders of keratin-associated proteins. Understanding the process of keratinization is essential for the pathogenesis of many dermatological diseases because improper desquamation and epidermopoiesis/keratinization (due to genetic mutations of factors or due to immune pathological processes) can lead to various conditions (ichthyoses, palmoplantar keratodermas, psoriasis, pityriasis rubra pilaris, epidermolytic hyperkeratosis, and others).
Topics: Humans; Skin; Epidermis; Cell Differentiation; Keratinocytes; Psoriasis
PubMed: 38203406
DOI: 10.3390/ijms25010236 -
Inflammation Apr 2024The mouse model of 2,4-dinitrochlorbenzene (DNCB)-induced human-like atopic dermatitis (hlAD) has been widely used to test novel treatment strategies and compounds....
The mouse model of 2,4-dinitrochlorbenzene (DNCB)-induced human-like atopic dermatitis (hlAD) has been widely used to test novel treatment strategies and compounds. However, the study designs and methods are highly diverse, presenting different hlAD disease patterns that occur after sensitization and repeated challenge with DNCB on dorsal skin. In addition, there is a lack of information about the progression of the disease during the experiment and the achieved pheno- and endotypes, especially at the timepoint when therapeutic treatment is initiated. We here examine hlAD in a DNCB-induced BALB/cJRj model at different timepoints: (i) before starting treatment with dexamethasone, representing a standard drug control (day 12) and (ii) at the end of the experiment (day 22). Both timepoints display typical AD-associated characteristics: skin thickening, spongiosis, hyper- and parakeratosis, altered cytokine and gene expression, increased lipid mediator formation, barrier protein and antimicrobial peptide abnormalities, as well as lymphoid organ hypertrophy. Increased mast cell infiltration into the skin and elevated immunoglobulin E plasma concentrations indicate a type I allergy response. The DNCB-treated skin showed an extrinsic moderate sub-acute hlAD lesion at day 12 and an extrinsic mild sub-acute to chronic pheno- and endotype at day 22 with a dominating Th2 response. A dependency of the filaggrin formation and expression in correlation to the disease severity in the DNCB-treated skin was found. In conclusion, our study reveals a detailed classification of a hlAD at two timepoints with different inflammatory skin conditions and pheno- and endotypes, thereby providing a better understanding of the DNCB-induced hlAD model in BALB/cJRj mice.
Topics: Dermatitis, Atopic; Animals; Dinitrochlorobenzene; Mice; Filaggrin Proteins; Disease Models, Animal; Mice, Inbred BALB C; Skin; Cytokines; Dexamethasone; Inflammation; Female
PubMed: 38150167
DOI: 10.1007/s10753-023-01943-x -
Journal of Advanced Research Dec 2023Rumen epithelial parakeratosis, a common disease in ruminants caused by abnormalities in the ruminal stratified squamous epithelial keratinization process, negatively...
INTRODUCTION
Rumen epithelial parakeratosis, a common disease in ruminants caused by abnormalities in the ruminal stratified squamous epithelial keratinization process, negatively impacts ruminant health and performance. However, we still lack a comprehensive perception of the underlying mechanisms and the predisposing factors for this disorder.
OBJECTIVES
Here, we investigated rumen epithelial cell heterogeneity, differentiation trajectories, and cornification to clarify the rumen epithelial keratinization process and discern the key ruminal metabolites contributing to rumen epithelial parakeratosis.
METHODS
Twenty-four 14-day-old lambs were divided into three groups, including only milk feeding, milk plus alfalfa hay feeding, and milk plus corn-soybean concentrate starter feeding. At 42 days of age, the lambs were slaughtered, and rumen tissues were collected for single-cell RNA-sequencing (scRNA-seq), immunofluorescence, and quantitative real-time PCR (qRT-PCR) analyses. Ruminal fluid samples were collected for metabolomic analyses. Rumen epithelial organoid was used to verify the key ruminal metabolites contributing to parakeratosis.
RESULTS
As expected, we observed that concentrate starter introduction resulted in rumen epithelial parakeratosis. Moreover, scRNA-seq analysis revealed a developmental impediment in the transition from differentiated keratinocytes to terminally differentiated keratinocytes (TDK) in lambs with concentrate starter introduction. Immunofluorescence and qRT-PCR analyses further verified the location and expression of marker genes of TDK. Metabolomic analysis showed a robust positive correlation between ruminal butyrate levels and rumen epithelial keratinization. More importantly, we successfully established a rumen organoid model capable of facilitating the study of the keratinization process in the rumen epithelia and further confirmed that high dose butyrate indeed contributed to rumen epithelial parakeratosis.
CONCLUSION
Collectively, concentrate starter introduction induces ruminal epithelial parakeratosis by blocking keratinocyte differentiation with excessive ruminal butyrate accumulation in a neonatal lamb model. These findings enhance our understanding of rumen epithelial keratinization and provide valuable insights for addressing rumen epithelial parakeratosis using early nutritional intervention strategies.
PubMed: 38128723
DOI: 10.1016/j.jare.2023.12.016 -
BioRxiv : the Preprint Server For... Dec 2023UBE2N, a Lys63-ubiquitin conjugating enzyme, plays critical roles in embryogenesis and immune system development and function. However, its roles in adult epithelial...
UBE2N, a Lys63-ubiquitin conjugating enzyme, plays critical roles in embryogenesis and immune system development and function. However, its roles in adult epithelial tissue homeostasis and pathogenesis are unclear. We generated conditional mouse models that deleted in skin cells in a temporally and spatially controlled manner. We found that knockout (KO) in the adult skin keratinocytes induced a range of inflammatory skin defects characteristic of psoriatic and actinic keratosis. These included eczematous inflammation, epidermal and dermal thickening, parakeratosis, and increased immune cell infiltration, as well as signs of edema and blistering. Single cell transcriptomic analyses and RT-qPCR showed that KO keratinocytes expressed elevated myeloid cell chemo-attractants such as and and decreased the homeostatic T lymphocyte chemo-attractant, . Consistently, the infiltrating immune cells of -KO skin were predominantly myeloid-derived cells including neutrophils and M1-like macrophages that were highly inflammatory, as indicated by expression of and Pharmacological blockade of the IL-1 receptor associated kinases (IRAK1/4) alleviated eczema, epidermal and dermal thickening, and immune infiltration of the mutant skin. Together, these findings highlight a key role of keratinocyte-UBE2N in maintenance of epidermal homeostasis and skin immunity and identify IRAK1/4 as potential therapeutic target for inflammatory skin disorders.
PubMed: 38105982
DOI: 10.1101/2023.12.01.569631 -
Cancers Nov 2023Actinic keratosis (AK), due to its widespread prevalence, as well as the possibility of progression to an invasive form of squamous cell carcinoma, requires treatment...
Actinic keratosis (AK), due to its widespread prevalence, as well as the possibility of progression to an invasive form of squamous cell carcinoma, requires treatment regardless of the clinical stage. New imaging techniques, such as in vivo reflectance confocal microscopy (RCM), significantly increase the accuracy of diagnosis and allow noninvasive evaluation of the therapeutic efficacy of the ongoing treatment. Our objective was to evaluate the prevalence of specific (video)dermoscopy and RCM features of pigmented and classical subtypes of AK before and after photodynamic therapy (PDT) treatment. We included patients with facial grade II AKs (25 pigmented, 275 non-pigmented) were included in the study. Skin lesions were evaluated by (video)dermoscopy and RCM at the baseline and three months after PDT. In classic AK, the most frequent dermoscopic findings were fine wavy vessels (96%), scale (92%), microerosions (48%), and "strawberry" pattern (36%), while pigmented AK was characterized mostly by "rhomboidal pattern" (80%), scale (60%), white globules (48%), "jelly sign", and superficial pigmentation (40%). RCM's most characteristic classic AK findings were abnormal honeycomb pattern in the spinous layer, epidermal inflammatory infiltrate, and solar elastosis that were present in 96% of lesions. Pigmented AKs presented mostly with dark central areas of parakeratosis (72%), mottled pigmentation (72%), dermal inflammatory infiltrate (64%), solar elastosis (60%), and abnormal honeycomb pattern in the spinous layer (56%). Dermoscopically, PDT resulted in complete disappearance of the "rhomboidal pattern" in both classical and pigmented AKs, "starburst pattern" and "jelly sign" in classical AKs, and inner gray halo, "rosette sign" and central crust in pigmented AKs. Three months after one PDT session, RCM evaluation showed mostly solar elastosis in both classical and pigmented AK subtypes, epidermal inflammatory infiltrate in classical AKs, and dermal inflammatory infiltrate in pigmented AKs. New noninvasive imaging techniques such as RCM and (video)dermoscopy can help practitioners better visualize the efficacy of the ongoing PDT treatment in either classical or pigmented AK subtypes.
PubMed: 38067302
DOI: 10.3390/cancers15235598 -
European Review For Medical and... Nov 2023Scabies is a skin infestation that has been known for hundreds of years and is caused by the ectoparasitis of Sarcoptes scabiei. Scabies is a public health problem that...
OBJECTIVE
Scabies is a skin infestation that has been known for hundreds of years and is caused by the ectoparasitis of Sarcoptes scabiei. Scabies is a public health problem that can be seen in all age groups, races, genders, socioeconomic groups, and all societies. The aim of this study was to identify the prominent histopathological findings in scabies cases and to guide the clinical approach.
PATIENTS AND METHODS
Scabies cases, which were clinically diagnosed between January 2016 and December 2020 in our hospital, were retrospectively screened, and 3,027 cases were detected. As a result of the screening, a skin punch biopsy-histopathological examination was performed in only 62 cases that were included in the study. Cases without punch biopsy were excluded from the study. After a histopathological evaluation, the cases were divided into two groups: those diagnosed with scabies (n=9) and those diagnosed with nonscabies (n=53). Pathological findings of the groups were statistically compared using Fisher's exact Chi-square test.
RESULTS
After microscopic examination, superficial and deep inflammatory reactions and the presence of lymphocytes were detected in 100% of cases. Furthermore, eosinophils and spongiosis were detected in 55% of cases. Histomorphological findings of the two groups were statistically examined and significant differences were found in spongiosis and eosinophil findings (p=0.019, p=0.025). There were no statistically significant differences in the other histopathological findings (parakeratosis, vesicle, bullae, intraepidermal pustule, vasculitis, dermal edema, superficial and deep inflammatory reaction, neutrophils, and plasma cells - p=0.259, p=0.266, p=0.083, p=0.683, p=0.557, p=0.066, p=0.980, p=0.290, and p=0.083, respectively).
CONCLUSIONS
In histopathological examination of scabies biopsies, spongiosis and eosinophil findings may be useful in differential diagnosis. Pathological diagnosis can be a decisive stage for controlling scabies, which has epidemic potential, especially in crowded environments such as schools, dormitories, and refugee camps. For pathology science to play an active role in the diagnosis of scabies, more punch biopsies are needed from cases. Large-sample prospective clinical studies comparing histopathological findings and the severity of the disease may contribute to the literature.
Topics: Female; Humans; Male; Scabies; Retrospective Studies; Prospective Studies; Skin; Inflammation; Plasma Cells
PubMed: 37975348
DOI: 10.26355/eurrev_202311_34299