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Indian Journal of Dermatology 2023Psoriasis is a chronic, immune-mediated skin disorder characterised by well-demarcated erythematous plaque with micaceous scale. Naevoid Blaschkoid psoriasis is an...
Psoriasis is a chronic, immune-mediated skin disorder characterised by well-demarcated erythematous plaque with micaceous scale. Naevoid Blaschkoid psoriasis is an unusual subtype that occurs along Blaschko lines. A two-year-old boy presented with erythematous scaly lesions distributed along the lines of Blaschko over the bilateral upper limb, the front of the chest, back, and the right lower limb. The lesions appeared four months ago and slowly progressed. There was no history of trauma, no skin lesions in other parts of the body, and no significant family history. Nail and mucosa were normal. Histopathology showed psoriasiform dermatitis with characteristics of psoriasis. The child was treated with topical clobetasol propionate 0.05% cream. Naevoid Blaschkoid psoriasis, in the absence of psoriatic lesion elsewhere on the body, is a rare manifestation. It has striking similarity with inflammatory linear verrucous epidermal nevus (ILVEN), both clinically and histologically. Naevoid psoriasis usually presents late, is asymptomatic or mildly pruritic, progresses rapidly, and responds favourably to antipsoriatic treatment. In contrast, ILVEN presents early, is intensely pruritic, slowly progressive, and is usually refractory to antipsoriatic treatment. Histologically, ILVEN demonstrates abruptly alternating areas of hypergranulosis with orthokeratosis, and parakeratosis with agranulosis. An inflammatory infiltrate is present in the upper dermis. Psoriasis presents with papillomatosis, acanthosis, and parakeratosis with absent or minimal granular layer. Immunohistochemical staining can be done in such doubtful cases. Involucrin would be detectable in psoriasis, but it is absent in ILVEN. Pathogenesis of linear psoriasis is unknown but might be explained by the concept of genetic mosaicism. Although rare, there have been a few reported cases of linear psoriasis occurring in early childhood.
PubMed: 37151253
DOI: 10.4103/ijd.ijd_894_22 -
Dermatology (Basel, Switzerland) 2023Dupilumab is the first approved IL-4Rα inhibitor for the treatment of atopic dermatitis at present with good efficacy and safety. However, there have been several... (Review)
Review
BACKGROUND
Dupilumab is the first approved IL-4Rα inhibitor for the treatment of atopic dermatitis at present with good efficacy and safety. However, there have been several reports of psoriasis and psoriasiform manifestations occurring after dupilumab therapy in recent years, showing a new paradoxical cutaneous reaction associated with biologics.
SUMMARY
This is a scoping review in order to summarize the demographics and epidemiology, clinical manifestations, diagnosis, potential pathogenesis, and promising management of dupilumab-associated psoriasis and psoriasiform manifestations.
Topics: Humans; Antibodies, Monoclonal, Humanized; Dermatitis, Atopic; Psoriasis; Interleukin-4; Interleukin Inhibitors; Treatment Outcome
PubMed: 37100035
DOI: 10.1159/000530608 -
Indian Dermatology Online Journal 2023Owing to the myriad clinical presentations of COVID-19 vaccine-induced adverse events, clinicopathological correlation is the key to understanding the underlying...
BACKGROUND
Owing to the myriad clinical presentations of COVID-19 vaccine-induced adverse events, clinicopathological correlation is the key to understanding the underlying pathophysiology of these reactions. However, there is still a dearth of such systematic studies across a wide spectrum of vaccine reactions.
AIM AND OBJECTIVES
This study provides a clinical and histopathological correlation of COVID-19 vaccine-induced mucocutaneous reactions.
MATERIALS AND METHODS
The study population included all the individuals developing any form of self-reported mucocutaneous adverse events within 4 weeks of receiving the COVID-19 vaccine. The clinical and histopathological features were recorded.
RESULTS
A total of 126 cases were identified. Seven histopathological patterns were recognized. The most common histopathological feature was spongiotic dermatitis, seen in all the patients with "vaccine-related eruption of papules and plaques" (VREPP). Other patterns included lichenoid or interface dermatitis, dermal hypersensitivity reaction, leukocytoclastic vasculitis, subepidermal blistering, psoriasiform hyperplasia, and dermal granulomatous reaction.
CONCLUSION
Owing to such myriad clinical presentations, utilizing a histopathological classification could ease categorizing the vaccine-induced mucocutaneous eruptions.
PubMed: 37089846
DOI: 10.4103/idoj.idoj_449_22 -
Frontiers in Allergy 2023Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy. Since the approval of ipilimumab in 2011, a total of nine ICIs have gained indications for... (Review)
Review
Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy. Since the approval of ipilimumab in 2011, a total of nine ICIs have gained indications for various solid and hematologic malignancies. The expanding use of ICIs in oncology underscores the need for diagnosis and treatment expertise in immune related adverse events (irAE). Cutaneous toxicities are the earliest and most common irAE in this class of therapy. In addition to the more frequent reactions including vitiligo, lichenoid dermatitis, psoriasiform dermatitis, other less common skin toxicities including bullous dermatoses, neutrophilic dermatoses, and autoimmune dermato-rheumatologic diseases have been reported. Even though less than 3% of cutaneous irAEs (irCAEs) are classified as grade 3 or higher events, irCAEs can greatly impact quality of life. Appropriate management of irCAEs is critical to avoid unwarranted interruptions or discontinuation of lifesaving immunotherapy.
PubMed: 36938327
DOI: 10.3389/falgy.2023.1147513 -
Bioengineering & Translational Medicine Mar 2023is an inflammatory disease characterized by distinctive skin lesions and dysregulated angiogenesis. Recent research uses stem cell secretion products (CM); a set of...
is an inflammatory disease characterized by distinctive skin lesions and dysregulated angiogenesis. Recent research uses stem cell secretion products (CM); a set of bioactive factors with therapeutic properties that regulate several cellular processes, including tissue repair and angiogenesis. The aim of this work was to evaluate the effect of CM of Wharton's gelatin MSC (hWJCM) in a treatment based on the bioactivation of a hyaluronic acid matrix (HA hWJCM) in a psoriasiform-like dermatitis (PD) mouse model. A preclinical study was conducted on PD mice. The effect of hWJCM, Clobetasol (Clob) gold standard, HA Ctrl, and HA hWJCM was tested topically evaluating severity of PD, mice weight as well as skin, liver, and spleen appearance. Treatment with either hWJCM, HA Ctrl or HA hWJCM, resulted in significant improvement of the PD phenotype. Moreover, treatment with HA hWJCM reduced the Psoriasis Area Severity Index (PASI), aberrant angiogenesis, and discomfort associated with the disease, leading to total recovery of body weight. We suggest that the topical application of HA hWJCM can be an effective noninvasive therapeutic solution for psoriasis, in addition to other skin diseases, laying the groundwork for future studies in human patients.
PubMed: 36925706
DOI: 10.1002/btm2.10443 -
JAAD Case Reports Mar 2023
PubMed: 36911793
DOI: 10.1016/j.jdcr.2023.01.012 -
International Journal of Molecular... Feb 2023Psoriasis is an inflammatory skin disease characterized by increased neo-vascularization, keratinocyte hyperproliferation, a pro-inflammatory cytokine milieu and immune...
Psoriasis is an inflammatory skin disease characterized by increased neo-vascularization, keratinocyte hyperproliferation, a pro-inflammatory cytokine milieu and immune cell infiltration. Diacerein is an anti-inflammatory drug, modulating immune cell functions, including expression and production of cytokines, in different inflammatory conditions. Therefore, we hypothesized that topical diacerein has beneficial effects on the course of psoriasis. The current study aimed to evaluate the effect of topical diacerein on imiquimod (IMQ)-induced psoriasis in C57BL/6 mice. Topical diacerein was observed to be safe without any adverse side effects in healthy or psoriatic animals. Our results demonstrated that diacerein significantly alleviated the psoriasiform-like skin inflammation over a 7-day period. Furthermore, diacerein significantly diminished the psoriasis-associated splenomegaly, indicating a systemic effect of the drug. Remarkably, we observed significantly reduced infiltration of CD11c dendritic cells (DCs) into the skin and spleen of psoriatic mice with diacerein treatment. As CD11c DCs play a pivotal role in psoriasis pathology, we consider diacerein to be a promising novel therapeutic candidate for psoriasis.
Topics: Animals; Mice; Spleen; Mice, Inbred C57BL; Skin; Psoriasis; Dermatitis; Cytokines; Dendritic Cells; Disease Models, Animal; Mice, Inbred BALB C
PubMed: 36901755
DOI: 10.3390/ijms24054324 -
Frontiers in Immunology 2023Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that block key mediators of tumor-mediated immune evasion. The frequency of its use has increased rapidly... (Review)
Review
Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that block key mediators of tumor-mediated immune evasion. The frequency of its use has increased rapidly and has extended to numerous cancers. ICIs target immune checkpoint molecules, such as programmed cell death protein 1 (PD-1), PD ligand 1 (PD-L1), and T cell activation, including cytotoxic T-lymphocyte-associated protein-4 (CTLA-4). However, ICI-driven alterations in the immune system can induce various immune-related adverse events (irAEs) that affect multiple organs. Among these, cutaneous irAEs are the most common and often the first to develop. Skin manifestations are characterized by a wide range of phenotypes, including maculopapular rash, psoriasiform eruption, lichen planus-like eruption, pruritus, vitiligo-like depigmentation, bullous diseases, alopecia, and Stevens-Johnson syndrome/toxic epidermal necrolysis. In terms of pathogenesis, the mechanism of cutaneous irAEs remains unclear. Still, several hypotheses have been proposed, including activation of T cells against common antigens in normal tissues and tumor cells, increased release of proinflammatory cytokines associated with immune-related effects in specific tissues/organs, association with specific human leukocyte antigen variants and organ-specific irAEs, and acceleration of concurrent medication-induced drug eruptions. Based on recent literature, this review provides an overview of each ICI-induced skin manifestation and epidemiology and focuses on the mechanisms underlying cutaneous irAEs.
Topics: Humans; Immune Checkpoint Inhibitors; Antineoplastic Agents, Immunological; Immunotherapy; Neoplasms; Drug Eruptions
PubMed: 36891313
DOI: 10.3389/fimmu.2023.1071983 -
Tropical Medicine and Infectious Disease Feb 2023Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first isolated in Wuhan, China, is currently a pandemic. At...
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first isolated in Wuhan, China, is currently a pandemic. At the beginning of the pandemic, pulmonary issues were the most discussed and studied. However, now 3 years later, the role of the dermatologist has become increasingly central. Often the diversity in the presentation of these manifestations has made it difficult for the dermatologist to recognize them. In addition to the common symptoms involving fever, cough, dyspnea, and hypogeusia/hyposmia that have been widely discussed in the literature, much attention has been paid to dermatologic manifestations in the past year. The vaccination campaign has been the most important strategy to combat the COVID-19 pandemic. Specifically, two viral vector-based vaccines [Vaxzervria (AstraZeneca; AZD1222) and COVID-19 Janssen vaccine (Johnson & Johnson; Ad26.COV2. S)] and two mRNA-based vaccines [Comirnaty (Pfizer/BioNTech; BNT162b2) and Spikevax (Moderna; mRNA-1273)]. However, several cutaneous adverse reactions have been reported following vaccination, making the dermatologist's role critical. It is possible to group these adverse reactions according to a classification with six main clinical pictures: urticarial rash, erythematous/maculopapular/morbid rash, papulovesicular rash, chilblain-like acral pattern, livedo reticularis/racemose-like, and purpuric "vasculitic" pattern. Beyond this classification, there are several reports of other dermatologic manifestations associated with the infection, such as pityriasis rosea, herpes zoster, or, particularly, the worsening of pre-existing chronic inflammatory dermatologic diseases. Here we report the case of a 61-year-old patient who presented at our clinic with a diffuse psoriasiform eruption mixed with a concomitant blistering rash induced by COVID-19. The uniqueness of our case has two features: the first is the concomitance of the two events after infection that seems to be unprecedented; the second is the management of the patient that could help dermatology colleagues in the management of these conditions during infection.
PubMed: 36828523
DOI: 10.3390/tropicalmed8020107