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Dermatology Online Journal Mar 2024
Topics: Humans; COVID-19; Animals; Hypersensitivity, Delayed; Bites and Stings; Male; Cnidarian Venoms; SARS-CoV-2; Scyphozoa; Female
PubMed: 38762871
DOI: 10.5070/D330163302 -
Dermatology Online Journal Mar 2024Steven-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is a rare immunologic hypersensitivity reaction to stimuli that presents as widespread eruption with...
Steven-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is a rare immunologic hypersensitivity reaction to stimuli that presents as widespread eruption with mucocutaneous detachment and involvement of other organs. Multiple causes have been noted in literature, including numerous medications. In this report, we present a 52-year-old woman who arrived at the emergency department with a complaint of rash, malaise, and pruritus. She subsequently developed diffuse cutaneous and mucosal detachment. Work-up supported a diagnosis of SJS/TEN secondary to her thyroid replacement therapy, derived from desiccated pig thyroid glands. The patient's natural thyroid medication was discontinued and she responded well to appropriate treatment. This case is unique in that thyroid replacement therapy is not a commonly reported trigger of SJS/TEN. Providers should be aware of the potential for natural thyroid and other animal-derived natural medications to cause adverse reactions such as SJS/TEN.
Topics: Stevens-Johnson Syndrome; Humans; Female; Middle Aged; Animals; Swine; Thyroid Gland
PubMed: 38762864
DOI: 10.5070/D330163294 -
Journal of the American Academy of... May 2024
PubMed: 38762011
DOI: 10.1016/j.jaad.2024.05.018 -
The National Medical Journal of India 2023Hepatic involvement in sarcoidosis, though common, is usually asymptomatic. Hepatomegaly and deranged liver function tests are the usual manifestations. However,...
Hepatic involvement in sarcoidosis, though common, is usually asymptomatic. Hepatomegaly and deranged liver function tests are the usual manifestations. However, unexplained hepatomegaly in sarcoidosis not responding to immunosuppressive therapy could indicate an alternative pathology. Haemophagocytic lymphohistiocytosis (HLH), although seldom reported in sarcoidosis, can cause hepatosplenomegaly and cytopenias. HLH occurring concomitantly with hepatic sarcoidosis is extremely rare. We report a patient of systemic sarcoidosis who presented with fever, hepatosplenomegaly and jaundice despite being on steroid therapy. He was subsequently diagnosed with HLH. The clinical response to treatment with pulse steroid and oral cyclosporine was dramatic.
Topics: Humans; Lymphohistiocytosis, Hemophagocytic; Sarcoidosis; Male; Cyclosporine; Hepatomegaly; Immunosuppressive Agents; Liver Diseases; Adult
PubMed: 38759982
DOI: 10.25259/NMJI_MS_314_21 -
Clinical Neurophysiology : Official... Jul 2024Infant hypersensitivity affects daily challenges and parental stress. Although the crucial role of tactile sensation in infants' brain function has been highlighted,...
OBJECTIVE
Infant hypersensitivity affects daily challenges and parental stress. Although the crucial role of tactile sensation in infants' brain function has been highlighted, hypersensitive infants and their families lack support. Electroencephalography may be useful for understanding hypersensitivity traits. We investigated the relationship between infant perceptual hypersensitivity and parental stress, somatosensory-evoked potential (SEP), and magnitude-squared coherence (MSC) in the general population.
METHODS
Infants aged 8 months (n = 63) were evaluated for hypersensitivity and parental stress using a questionnaire and for cortical activity using electroencephalography. Vibration stimuli were applied to the infant's left foot. SEP components that peaked around 150 ms (N2) and at 200 ms (P2) after stimulus onset were evaluated by amplitude and latency at the midline electrode (Cz) and MSC between the midline electrodes (C3-C4).
RESULTS
Parental stress was associated with infant hypersensitivity. The latency of Cz was delayed, and C3-C4 delta MSC was high in infants with hypersensitivity.
CONCLUSIONS
Increasing inter-hemispheric MSC synchrony in the stimulated condition in infants with hypersensitivity suggested atypical somatosensory cortical function.
SIGNIFICANCE
These findings contribute to identifying, understanding the mechanisms of, and developing effective coping strategies for early-stage hypersensitivity.
Topics: Humans; Male; Female; Infant; Electroencephalography; Evoked Potentials, Somatosensory; Parents; Stress, Psychological; Somatosensory Cortex; Hypersensitivity
PubMed: 38759514
DOI: 10.1016/j.clinph.2024.04.015 -
FASEB Journal : Official Publication of... May 2024Mesenchymal stromal cells (MSCs) have been shown to modulate the function of various subsets of T cells such as naïve CD4 T cells and IFNγCD4 Th1 cells; however,...
Mesenchymal stromal cells (MSCs) have been shown to modulate the function of various subsets of T cells such as naïve CD4 T cells and IFNγCD4 Th1 cells; however, mechanisms underlying this regulation have not been fully deciphered. Our in vitro culture assays demonstrate that MSCs suppress the activation and function of CD4 T cells by secreting interleukin 11, and neutralization of IL11 abrogates MSC-mediated suppression of CD4 T cell function. Moreover, delayed-type, exogenous supplementation of IL11 significantly suppressed IFNγ expression by Th1 cells. Th1 and CD8 cells play central roles in T cell-mediated tissue damage. Using a murine model of hypersensitivity response to study T cell-mediated tissue damage, we show that silencing IL11 in MSCs significantly abates the capacity of MSCs to suppress the generation of IFNγ-secreting CD4 and CD8 cells, failing to prevent T cell-mediated tissue inflammation and tissue damage.
Topics: Animals; Mesenchymal Stem Cells; Th1 Cells; Mice; Interleukin-11; Mice, Inbred C57BL; CD8-Positive T-Lymphocytes; Interferon-gamma; CD4-Positive T-Lymphocytes; Cells, Cultured; Female
PubMed: 38758184
DOI: 10.1096/fj.202400078R -
The British Journal of Dermatology May 2024
Topics: Humans; Dermatitis, Allergic Contact; Female; Male; Adult; Middle Aged; Dental Materials; Patch Tests; Aged
PubMed: 38758061
DOI: 10.1093/bjd/ljae160 -
Allergologie Select 2024Allergic contact dermatitis is one of the most frequent occupational skin diseases. Targeted allergen avoidance can only be achieved by identification of the causative... (Review)
Review
Allergic contact dermatitis is one of the most frequent occupational skin diseases. Targeted allergen avoidance can only be achieved by identification of the causative allergen. Therefore, patch testing is of utmost importance in occupational dermatology, not only in terms of assessing causal relationships but also regarding the implementation of prevention measures and evaluation of the legal criteria for an occupational skin disease in Germany (statutory occupational disease BK 5101). The lack of commercial patch test preparations poses a great diagnostic challenge. Patch testing of patient's own materials from their workplace is therefore very important to reduce diagnostic gaps. The performance and documentation of the patch test should be in line with current guidelines and recommendations to ensure the necessary test quality and comprehensibility of the test results.
PubMed: 38756208
DOI: 10.5414/ALX2483E -
Allergy and Asthma Proceedings May 2024Concern of metal sensitization in pre- and postsurgical evaluation is growing, with the recent guidelines remaining the criterion standard for consideration of patch...
Concern of metal sensitization in pre- and postsurgical evaluation is growing, with the recent guidelines remaining the criterion standard for consideration of patch testing. Information remains scarce on surgical screening in the groups of patients who reported a history of metal sensitivity versus those with no reported history. The objective of this study was to assess the utility of patch testing in surgical candidates based on reported metal allergy history. The secondary objective was to evaluate the utility and outcomes in postsurgical patch testing. Nine hundred and thirty-one patient charts of patients with the diagnosis of "contact dermatitis" who underwent an evaluation at a single allergy clinic site between January 2013 and December 2022 were identified and reviewed as part of a retrospective chart review study. Patients were included in subgroups based on the time of patch testing and history of reported metal allergy. In all, 67 patients underwent patch testing, 10 (14.9%) of whom were surgical candidates without a history of metal sensitivity, 31 (46.2%) of whom were surgical candidates with a history of metal sensitivity, and 26 (38.8%) of whom were postsurgical patients. Twenty-nine (43.3%) of patients had positive patch testing results, with only one (10%) in the presurgical group, 17 (54.8%) in the presurgical with a history of metal sensitivity, and 11 (42.3%) in the postsurgical group. Zero patients in our cohort without metal sensitivity who were undergoing the Nuss procedure had positive reactions on patch testing, whereas two of four (50%) with reported metal sensitivity who were undergoing the Nuss procedure had positive relevant metal reactions. Ambiguity in the utility of patch testing for surgical decision making remains, despite common utilization. Recent guidelines along with coordination of care among the surgeon, allergist, and patient remains the criterion standard of care.
Topics: Humans; Retrospective Studies; Patch Tests; Metals; Male; Female; Middle Aged; Prostheses and Implants; Adult; Dermatitis, Allergic Contact; Aged; Allergens
PubMed: 38755777
DOI: 10.2500/aap.2024.45.240005 -
American Journal of Clinical Dermatology Jul 2024Drug reaction with eosinophilia and systemic symptoms (DReSS) is known to cause mortality and long-term sequelae in the pediatric population, however there are no... (Review)
Review
Drug reaction with eosinophilia and systemic symptoms (DReSS) is known to cause mortality and long-term sequelae in the pediatric population, however there are no established clinical practice guidelines for the management of pediatric DReSS. We conducted a scoping review, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to summarize the currently available data on treatment, mortality, and long-term sequelae of DReSS in children (aged 0-18 years). Data from 644 individuals revealed that various treatment strategies are being used in the management of pediatric DReSS, and strategies were often used in combination. The diversity in treatment approaches cannot be solely attributed to age or disease severity and reflects the lack of evidence-based management guidelines for DReSS. Children are also at risk of developing autoimmune sequelae following DReSS, most commonly thyroid disease and type 1 diabetes mellitus. We found that the eventual development of autoimmune disease was more often associated with DReSS caused by antibiotics, especially minocycline and sulfamethoxazole, in comparison with individuals who did not develop sequelae. In this study, we identify strengths and weaknesses in the currently available literature and highlight that future prospective studies with structured and long-term follow-up of children with DReSS are needed to better understand potential risk factors for mortality and development of sequelae after DReSS.
Topics: Humans; Drug Hypersensitivity Syndrome; Child; Adolescent; Child, Preschool; Infant; Risk Factors; Anti-Bacterial Agents; Treatment Outcome; Autoimmune Diseases; Severity of Illness Index
PubMed: 38755503
DOI: 10.1007/s40257-024-00867-y