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Cureus Apr 2022Granular parakeratosis (GP) is a rare, idiopathic, and self-limiting cutaneous disorder. It clinically presents as erythematous to brown hyperkeratotic or scaly papules...
Granular parakeratosis (GP) is a rare, idiopathic, and self-limiting cutaneous disorder. It clinically presents as erythematous to brown hyperkeratotic or scaly papules that can coalesce to form plaques. If GP is suspected clinically, histopathological confirmation is adequate for diagnosis. Several treatment modalities were tried with varying success, but none was consistently efficacious. Given the rarity of GP and the variety in its clinical presentation and management, we report a case of a self-resolving infra-abdominal GP. Our patient is a 47-year-old female who presented with a one-week history of asymptomatic, multiple, linear, horizontal, brown, hyperpigmented scaly papules in the infra-abdominal fold. She had a three-year history of applying almond oil and Sudocrem Antiseptic Healing Cream®. Histopathology showed the retention of basophilic keratohyalin granules within the area of parakeratosis in the stratum corneum, which is consistent with GP. She was discharged on emollients, and on follow-up one month later, her lesions completely resolved. In conclusion, GP is a rare cutaneous disorder characterized by hyperkeratotic plaques or papules typically on intertriginous areas. The natural history of the disease may vary from spontaneous resolution to a waxing and waning condition. In addition, given how uncommon the disease is and its variable etiologies and course, definite management is yet to be established and a standardized treatment recommendation is lacking.
PubMed: 35573563
DOI: 10.7759/cureus.24085 -
Molecules (Basel, Switzerland) May 20222-(4-Chlorophenyl)-5-benzoxazoleacetic acid (CBA) and its ester, methyl-2-(4-chloro-phenyl)-5-benzoxazoleacetate (MCBA), were synthesized, and their structures were...
2-(4-Chlorophenyl)-5-benzoxazoleacetic acid (CBA) and its ester, methyl-2-(4-chloro-phenyl)-5-benzoxazoleacetate (MCBA), were synthesized, and their structures were confirmed by HNMR, IR, and mass spectrophotometry. The anti-psoriatic activities of CBA and MCBA were tested using an imiquimod (IMQ)-induced psoriatic mouse model, in which mice were treated both topically (1% ) and orally (125 mg/kg) for 14 days. The erythema intensity, thickness, and desquamation of psoriasis were scored by calculating the psoriasis area severity index (PASI). The study also included the determination of histopathological alterations in the skin tissues of treated mice. Topical and oral administration of CBA and MCBA led to a reduction in erythema intensity, thickness, and desquamation, which was demonstrated by a significant decrease in the PASI value. In addition, skin tissues of mice treated with CBA and MCBA showed less evidence of psoriatic alterations, such as hyperkeratosis, parakeratosis, scale crust, edema, psoriasiform, and hyperplasia. After administration of either topical or oral dosing, the anti-psoriatic effects were found to be stronger in MCBA-treated than in CBA-treated mice. These effects were comparable to those produced by Clobetasol propionate, the reference drug. This drug discovery could be translated into a potential new drug for future clinical use in psoriasis treatment.
Topics: Animals; Benzoxazoles; Disease Models, Animal; Imiquimod; Mice; Mice, Inbred CBA; Pharmaceutical Preparations; Psoriasis; Skin
PubMed: 35566373
DOI: 10.3390/molecules27093023 -
Journal of Lower Genital Tract Disease Jul 2022The aim of the study was to evaluate clinicopathologic features of cases demonstrating an acanthotic tissue reaction not clearly consistent with psoriasis, lichen...
OBJECTIVE
The aim of the study was to evaluate clinicopathologic features of cases demonstrating an acanthotic tissue reaction not clearly consistent with psoriasis, lichen simplex chronicus, mycosis, or condyloma.
MATERIALS AND METHODS
This is a retrospective pathologic case series of biopsies reported as "benign acanthotic lesion" and "acanthotic tissue reaction" that lacked a clear diagnosis on expert review. Cases with nuclear atypia were excluded. Clinical and histopathologic data were collected, immunohistochemistry for p16 and p53 were obtained, and molecular testing for 28 common anogenital human papillomavirus (HPV) genotypes was undertaken.
RESULTS
There were 17 cases with a median age of 47 years. Unilaterality and medial location were clinical reasons for diagnostic difficulty. Histopathologic uncertainty often related to lack of papillary dermal fibrosis to support lichen simplex chronicus or psoriasiform lesions without parakeratosis, subcorneal pustules, and/or mycotic elements. Firm pathologic diagnoses were not possible, but 3 groups emerged: favoring chronic dermatitis, favoring psoriasis, and unusual morphologies. p16 results were negative or nonblock positive while p53 was normal or basal overexpressed. Human papillomavirus testing was negative in 12, low positive for HPV 16 in 1, unassessable in 3, and not requested in 1.
CONCLUSIONS
There is a group of acanthotic tissue reactions that cannot be classified with standard histopathologic assessment. Further clinicopathologic research into unilateral acanthotic lesions may provide insight into separation of psoriasis and mycosis when organisms are absent. Once nuclear atypia is excluded, immunohistochemistry for p16 and p53 and HPV molecular testing do not assist in diagnostic identification.
Topics: Alphapapillomavirus; Female; Humans; Middle Aged; Neurodermatitis; Papillomaviridae; Papillomavirus Infections; Psoriasis; Retrospective Studies; Tumor Suppressor Protein p53; Vulvar Neoplasms
PubMed: 35543596
DOI: 10.1097/LGT.0000000000000681 -
Case Reports in Dermatology 2022Genital psoriasis is a debilitating condition affecting approximately 49% of male psoriasis patients at least once during their lifetime. This condition often presents...
Genital psoriasis is a debilitating condition affecting approximately 49% of male psoriasis patients at least once during their lifetime. This condition often presents as generalized plaque psoriasis and features well-demarcated, erythematous plaques affecting the glans penis and corona. Presentations of male genital psoriasis which disagree with this description may be under- or misdiagnosed, delaying appropriate management. We present the first reported case of chronic plaque psoriasis affecting the penile shaft without involvement of the glans. Both consistent histologic and non-cutaneous features of psoriasis facilitated diagnosis in this patient. The sclerotic plaque on the patient's penile shaft resolved following biologic therapy for psoriasis. This rare presentation of genital psoriasis highlights important learning points for clinicians and dermatopathologists. First, genital psoriasis may affect the penile shaft without involvement of the glans penis. Second, non-cutaneous signs of psoriasis can inform diagnosis when clinical presentation is atypical. Third, psoriasis exhibits a broad spectrum of histopathology.
PubMed: 35496507
DOI: 10.1159/000523818 -
Iranian Journal of Pathology 2022Nevus comedonicus (NC) is a rare developmental anomaly of the folliculosebaceous apparatus, which appears as numerous dilated papules containing firm, darkly pigmented,...
Nevus comedonicus (NC) is a rare developmental anomaly of the folliculosebaceous apparatus, which appears as numerous dilated papules containing firm, darkly pigmented, horny plugs. It appears shortly after birth and mostly before the age of 10; however, late-onset cases have been reported. There is no gender or racial predilection. Moreover, NC can be a component of nevus comedonicus syndrome, a neurocutaneous disorder with skeletal, ocular, and central nervous system abnormalities. EHK properties in NC are not a common finding and are rarely seen in association with each other. This paper reports a healthy, 27-year-old young woman who has been developing numbers of asymptomatic unilateral linear skin lesions on her chest, waist, right thigh, and popliteal fossa in a unilateral linear pattern over ten years. Skin biopsy revealed dilated follicular ostia with orthokeratotic hyperkeratosis, columns of parakeratosis, cornoid flagellation, epidermolytic hyperkeratosis, and mild acanthosis on its wall.
PubMed: 35463735
DOI: 10.30699/IJP.2022.542761.2767 -
International Medical Case Reports... 2022Kyrle's disease (KD) is a rare type of acquired perforating dermatosis (APD) associated with various systemic diseases, particularly chronic kidney disease and diabetes...
Kyrle's disease (KD) is a rare type of acquired perforating dermatosis (APD) associated with various systemic diseases, particularly chronic kidney disease and diabetes mellitus (DM). It most commonly occurs at the lower extremities. Generalized lesions of KD are rare. We report a case of generalized KD in a 29-year-old woman with chronic kidney disease and DM. Physical examination revealed multiple hyperkeratotic and hyperpigmented papules, plaques, and nodules with central umbilication and keratotic plugs on almost all parts of the body. Histopathological examination showed keratinized epithelial layer with acanthosis and hyperkeratosis, invagination with the formation of keratin plugs, and basophilic cell debris accompanied by parakeratosis and abnormal keratinization of epithelial cells. These histopathological findings fulfilled the Constantine and Carter criteria for KD. This condition is characterized clinically by umbilicated, round, erythematous or hyperpigmented papules and nodules with central crusts or keratotic plug, predominantly involving the extensor surfaces of the extremities and the trunk. Although uncommon, it may also involve the face or the scalp. Nevertheless, generalized lesions involving faces are rarely found in KD.
PubMed: 35437356
DOI: 10.2147/IMCRJ.S358523 -
Journal of Cutaneous Pathology Jul 2022
Topics: Carcinoma, Squamous Cell; Humans; Nail Diseases; Nails; Parakeratosis; Skin Neoplasms
PubMed: 35416321
DOI: 10.1111/cup.14241 -
Journal of Inflammation Research 2022As a multifunctional cytokine, lipocalin 2 is weakly expressed in skin and serum under normal conditions. However, it is over-expressed by neutrophils and keratinocytes... (Review)
Review
As a multifunctional cytokine, lipocalin 2 is weakly expressed in skin and serum under normal conditions. However, it is over-expressed by neutrophils and keratinocytes in the skin lesions and sera in several skin diseases. Recent studies demonstrated that lipocalin 2 participates in the pathogenesis of psoriasis by exerting versatile effects on skin resident cells and infiltrating immune cells. Lipocalin 2 inhibits the synthesis of keratin, involucrin, and loricrin in keratinocytes, leading to epidermal parakeratosis via the Tcf7l1-lipocalin 2 signaling axis. It also recruits inflammatory cells such as T cells and neutrophils into skin lesions via the IL-23/IL17, p38-MAPK, and ERK-1/2 signaling pathways. Additionally, lipocalin 2 and other cytokines such as IL-17 have the synergetic effects on skin cells. The neutralization of lipocalin 2 or relevant cytokines can alleviate psoriasis, verifying that lipocalin 2 is an effective interfering target for psoriasis. In this review, we summarize the roles of lipocalin 2 in the processes of psoriatic inflammation and the promising therapeutic strategies based on lipocalin 2-related molecules.
PubMed: 35386225
DOI: 10.2147/JIR.S358492 -
Annals of Translational Medicine Jan 2022Psoriasis is an immune-mediated chronic, recurrent, inflammatory skin disease. In view of the research on the relationship between stem cells and the pathogenesis of...
BACKGROUND
Psoriasis is an immune-mediated chronic, recurrent, inflammatory skin disease. In view of the research on the relationship between stem cells and the pathogenesis of psoriasis, stem cells may be a new breakthrough in the systemic treatment of psoriasis.
METHODS
The BALB/c mouse psoriasis-like model induced by imiquimod was established and animals were randomly divided into a control group, model group, human umbilical cord mesenchymal stem cells (hUC-MSCs) group with different concentrations (injected separately with umbilical cord stem cells 1×10/kg, 2×10/kg, 4×10/kg through the caudal vein) and fresh hUC-MSCs group (injected with fresh umbilical cord stem cells 2×10/kg through the tail vein). The Psoriasis Area and Severity Index (PASI) score was used to observe the changes in skin lesions. The epidermal thickness, degree of keratinization and infiltration of inflammatory cells were observed by HE staining. The concentrations of -α, -γ, , and other cytokines in serum and skin of mice were measured by enzyme-linked immunosorbent assay (ELISA).
RESULTS
Mice treated with hUC-MSCs showed a good dose-response dependence compared with the control group. As the concentration of hUC-MSCs increased, so did the spleen index. According to the PASI integral trend chart, hUC-MSCs can delay the appearance of skin lesions and accelerate the recovery of skin lesions. HE staining showed that the number of parakeratosis cells in the hUC-MSCs treatment group was significantly decreased, and the degree of dermal hyperplasia and inflammatory cell infiltration in erythrocyte extravasation was significantly lower than in the model group. The higher the concentration of hUC-MSCs, the lower the concentration of the four cytokines in serum and skin tissue.
CONCLUSIONS
hUC-MSCs had an obvious therapeutic effect on imiquimod-induced psoriasis in mice, and a high concentration of hUC-MSCs had the best therapeutic effect. This effect intensity is dose-dependent, and hUC-MSCs at high concentrations have better therapeutic effect.
PubMed: 35282132
DOI: 10.21037/atm-22-4 -
Clinical Epigenetics Mar 2022Psoriasis is a chronic and hyperproliferative skin disease featured by hyperkeratosis with parakeratosis, Munro micro-abscess, elongation of rete pegs, granulosa...
BACKGROUND
Psoriasis is a chronic and hyperproliferative skin disease featured by hyperkeratosis with parakeratosis, Munro micro-abscess, elongation of rete pegs, granulosa thinning, and lymphocyte infiltration. We previously profiled gene expression and chromatin accessibility of psoriatic skins by transcriptome sequencing and ATAC-seq. However, integrating both of these datasets to unravel gene expression regulation is lacking. Here, we integrated transcriptome and ATAC-seq of the same psoriatic and normal skin tissues, trying to leverage the potential role of chromatin accessibility and their function in histopathology features.
RESULTS
By inducing binding and expression target analysis (BETA) algorithms, we explored the target prediction of transcription factors binding in 15 psoriatic and 19 control skins. BETA identified 408 upregulated genes (rank product < 0.01) and 133 downregulated genes linked with chromatin accessibility. We noticed that cumulative fraction of genes in upregulation group was statistically higher than background, while that of genes in downregulation group was not significant. KEGG pathway analysis showed that the upregulated 408 genes were enriched in TNF, NOD, and IL-17 signaling pathways. In addition, the motif module in BETA suggested the 57 upregulated genes are targeted by transcription factor AP-1, indicating that increased chromatin accessibility facilitated the binding of AP-1 to the target regions and further induced expression of relevant genes. Among these genes, SQLE, STRN, EIF4, and MYO1B expression was increased in patients with hyperkeratosis, parakeratosis, and acanthosis thickening.
CONCLUSIONS
In summary, with the advantage of BETA, we identified a series of genes that contribute to the disease pathogenesis, especially in modulating histopathology features, providing us with new clues in treating psoriasis.
Topics: Chromatin; DNA Methylation; Humans; Parakeratosis; Psoriasis; Transcription Factor AP-1; Transcriptome
PubMed: 35277199
DOI: 10.1186/s13148-022-01250-6