Prominent changes in the gut microbiota (referred to as “dysbiosis”) play a key role in the development of allergic disorders, but the underlying mechanisms remain unknown. Study of the delayed-type ...hypersensitivity (DTH) response in mice contributed to our knowledge of the pathophysiology of human allergic contact dermatitis. Here we report a negative regulatory role of the RIG-I–like receptor adaptor mitochondrial antiviral signaling (MAVS) on DTH by modulating gut bacterial ecology. Cohousing and fecal transplantation experiments revealed that the dysbiotic microbiota of Mavs
−/− mice conferred a proallergic phenotype that is communicable to wild-type mice. DTH sensitization coincided with increased intestinal permeability and bacterial translocation within lymphoid organs that enhanced DTH severity. Collectively, we unveiled an unexpected impact of RIG-I–like signaling on the gut microbiota with consequences on allergic skin disease outcome. Primarily, these data indicate that manipulating the gut microbiota may help in the development of therapeutic strategies for the treatment of human allergic skin pathologies.
Keratoacanthoma (KA): An update and review Kwiek, Bartlomiej, MD, PhD; Schwartz, Robert A., MD, MPH
Journal of the American Academy of Dermatology,
06/2016, Letnik:
74, Številka:
6
Journal Article
Recenzirano
Keratoacanthoma (KA) is a common but underreported tumor of the skin. Two striking features of KA are its clinical behavior with spontaneous regression after rapid growth and its nosological position ...on the border between benignity and malignancy. We review current knowledge on the clinical, histopathological, and dermoscopic features of KA to ensure a proper diagnosis and describe its variants, including different types of multiple KAs. We highlight current concepts of KA ethiopathogenesis with special emphasis on the genetic background of multiple familial KA, the role of Wnt signaling pathway, and induction of KA by BRAF inhibitors and procedures of esthetic dermatology. Finally, treatment strategies are presented with surgical excision as a first option, followed by other modalities, including intralesional chemotherapy, topical and systemic agents, lasers, cryotherapy, and photodynamic therapy.
Curcumin is a compound isolated from turmeric, a plant known for its medicinal use. Recently, there is a growing interest in the medical community in identifying novel, low-cost, safe molecules that ...may be used in the treatment of inflammatory and neoplastic diseases. An increasing amount of evidence suggests that curcumin may represent an effective agent in the treatment of several skin conditions. We examined the most relevant in vitro and in vivo studies published to date regarding the use of curcumin in inflammatory, neoplastic, and infectious skin diseases, providing information on its bioavailability and safety profile. Moreover, we performed a computational analysis about curcumin's interaction towards the major enzymatic targets identified in the literature. Our results suggest that curcumin may represent a low-cost, well-tolerated, effective agent in the treatment of skin diseases. However, bypass of limitations of its in vivo use (low oral bioavailability, metabolism) is essential in order to conduct larger clinical trials that could confirm these observations. The possible use of curcumin in combination with traditional drugs and the formulations of novel delivery systems represent a very promising field for future applicative research.
Summary
Reticulate pigmentary disorders are a group of disorders characterized by hyper‐ and/or hypopigmented macules with varying sizes and amounts of pigment. Some of the disorders are heritable, ...such as Dowling‐Degos disease, dyschromatosis universalis hereditaria, dyschromatosis symmetrica hereditaria, reticulate acropigmentation of Kitamura and X‐linked reticulate pigmentary disorder. Although each condition possesses unique phenotypic characteristics and the prognosis for each is somewhat different, there is a large degree of overlap between the disorders and therefore they are difficult to differentiate in the clinical setting. This updated review provides a clinical and molecular delineation of these genetic reticulate pigmentary disorders and aims to establish a concise diagnostic strategy to allow clinical dermatologists to make an accurate diagnosis, as well as to provide useful information for clinical and genetic counselling.
What's already known about this topic?
Reticulate pigmentary disorders are a group of diseases characterized by mottled hyperpigmented and/or hypopigmented macules with distinct distribution and varying sizes and amounts of pigment.
What does this study add?
A comprehensive knowledge of genetic reticulate pigmentary disorders is essential for clinical and genetic counselling.
This review provides a clinical and molecular delineation of these overlapping disorders, and aims to provide useful information that enables dermatologists to make a definitive diagnosis.
Linked Comment: Betz. Br J Dermatol 2017; 177:893–894.
Oriol Mitjà * E-mail: oriol.mitja@isglobal.org Affiliations Skin NTDs Program, Barcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain, Division of Public ...Health, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea ORCID http://orcid.org/0000-0003-3266-8868 Michael Marks Affiliations Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom, Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, United Kingdom ORCID http://orcid.org/0000-0002-7585-4743 Laia Bertran Affiliation: Skin NTDs Program, Barcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain Karsor Kollie Affiliation: Neglected Tropical and Non Communicable Diseases Program, Ministry of Health, Government of Liberia, Liberia Daniel Argaw Affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland Ahmed H. Fahal Affiliation: The Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan Christopher Fitzpatrick Affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland L. Claire Fuller Affiliation: International Foundation for Dermatology, London, United Kingdom Bernardo Garcia Izquierdo Affiliation: Anesvad foundation, Bilbao, Spain Roderick Hay Affiliation: International Foundation for Dermatology, London, United Kingdom Norihisa Ishii Affiliation: Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan Christian Johnson Affiliation: Fondation Raoul Follereau, Cotonou, République du Bénin Jeffrey V. Lazarus Affiliation: Skin NTDs Program, Barcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain Anthony Meka Affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Nigeria Michele Murdoch Affiliation: Department of Dermatology, Watford General Hospital, Watford, United Kingdom Sally-Ann Ohene Affiliation: World Health Organization Country Office, Accra, Ghana Pam Small Affiliation: Department of Microbiology, University of Tennessee, Knoxville, Tennessee, United States of America Andrew Steer Affiliation: Group A Streptococcal Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia Earnest N. Tabah Affiliation: National Yaws, Leishmaniasis, Leprosy and Buruli ulcer Control Programme, Ministry of Public Health, Yaoundé, Cameroon Alexandre Tiendrebeogo Affiliation: World Health Organization Regional Office for Africa, Brazzaville, Congo Lance Waller Affiliation: Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America Rie Yotsu Affiliation: Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan Stephen L. Walker Affiliation: Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom Kingsley Asiedu Affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, SwitzerlandCitation: Mitjà O, Marks M, Bertran L, Kollie K, Argaw D, Fahal AH, et al. Research * Validating a clinical algorithm for identification of skin NTDs using key symptoms and signs. * Developing common clinical and laboratory diagnostic platforms for these diseases, which are practical in the field. * Mapping to identify their overlap to allow integrated coordinated control and treatment activities as well as health system strengthening for service delivery. * Piloting the integrated approach in one or several regions. * Better understanding of the epidemiology of these diseases including transmission and interaction with poverty and water, sanitation, and hygiene (WASH). * Understand community resilience and program factors that strengthen community participation.
Skin changes in the obese patient Hirt, Penelope A.; Castillo, David E.; Yosipovitch, Gil ...
Journal of the American Academy of Dermatology,
November 2019, 2019-Nov, 2019-11-00, 20191101, Letnik:
81, Številka:
5
Journal Article
Recenzirano
Obesity is a worldwide major public health problem with an alarmingly increasing prevalence over the past 2 decades. The consequences of obesity in the skin are underestimated. In this paper, we ...review the effect of obesity on the skin, including how increased body mass index affects skin physiology, skin barrier, collagen structure, and wound healing. Obesity also affects sebaceous and sweat glands and causes circulatory and lymphatic changes. Common skin manifestations related to obesity include acanthosis nigricans, acrochordons, keratosis pilaris, striae distensae, cellulite, and plantar hyperkeratosis. Obesity has metabolic effects, such as causing hyperandrogenism and gout, which in turn are associated with cutaneous manifestations. Furthermore, obesity is associated with an increased incidence of bacterial and Candida skin infections, as well as onychomycosis, inflammatory skin diseases, and chronic dermatoses like hidradenitis suppurativa, psoriasis, and rosacea. The association between atopic dermatitis and obesity and the increased risk of skin cancer among obese patients is debatable. Obesity is also related to rare skin conditions and to premature hair graying. As physicians, understanding these clinical signs and the underlying systemic disorders will facilitate earlier diagnoses for better treatment and avoidance of sequelae.
Atopic dermatitis (AD) affects up to 20% of children worldwide and is an increasing public health problem, particularly in developed countries. Although AD in infants and young children can resolve, ...there is a well-recognized increased risk of sequential progression from AD to other atopic diseases, including food allergy (FA), allergic rhinitis, allergic asthma, and allergic rhinoconjunctivitis, a process referred to as the atopic march. The mechanisms underlying the development of AD and subsequent progression to other atopic comorbidities, particularly FA, are incompletely understood and the subject of intense investigation. Other major research objectives are the development of effective strategies to prevent AD and FA, as well as therapeutic interventions to inhibit the atopic march. In 2017, the Division of Allergy, Immunology, and Transplantation of the National Institute of Allergy and Infectious Diseases sponsored a workshop to discuss current understanding and important advances in these research areas and to identify gaps in knowledge and future research directions. International and national experts in the field were joined by representatives from several National Institutes of Health institutes. Summaries of workshop presentations, key conclusions, and recommendations are presented herein.
Curcumin, a natural polyphenolic and yellow pigment obtained from the spice turmeric, has strong antioxidative, anti‐inflammatory, and antibacterial properties. Due to these properties, curcumin has ...been used as a remedy for the prevention and treatment of skin aging and disorders such as psoriasis, infection, acne, skin inflammation, and skin cancer. Curcumin has protective effects against skin damage caused by chronic ultraviolet B radiation. One of the challenges in maximizing the therapeutic potential of curcumin is its low bioavailability, limited aqueous solubility, and chemical instability. In this regard, the present review is focused on recent studies concerning the use of curcumin for the treatment of skin diseases, as well as offering new and efficient strategies to optimize its pharmacokinetic profile and increase its bioavailability.
Curcumin, a natural polyphenolic and yellow pigment obtained from the spice turmeric, has strong antioxidative, anti‐inflammatory, and antibacterial properties; due to these properties, curcumin has been used as a remedy for the prevention and treatment of skin aging and disorders such as psoriasis, infection, acne, skin inflammation, and skin cancer and curcumin has protective effects against skin damage caused by chronic ultraviolet B radiation. One of the challenges in maximizing the therapeutic potential of curcumin is its low bioavailability, limited aqueous solubility, and chemical instability; in this regard, the present review is focused on recent studies concerning the use of curcumin for the treatment of skin diseases, as well as offering new and efficient strategies to optimize its pharmacokinetic profile and increase its bioavailability.
AIM2 is a cytosolic innate immune receptor which recognizes double‐stranded DNA (dsDNA) released during cellular perturbation and pathogenic assault. AIM2 recognition of dsDNA leads to the assembly ...of a large multiprotein oligomeric complex termed the inflammasome. This inflammasome assembly leads to the secretion of bioactive interleukin‐1β (IL‐1β) and IL‐18 and induction of an inflammatory form of cell death called pyroptosis. Sensing of dsDNA by AIM2 in the cytosol is crucial to mediate protection against the invading pathogens including bacteria, virus, fungi and parasites. AIM2 also responds to dsDNA released from damaged host cells, resulting in the secretion of the effector cytokines thereby driving the progression of sterile inflammatory diseases such as skin disease, neuronal disease, chronic kidney disease, cardiovascular disease and diabetes. Additionally, the protection mediated by AIM2 in the development of colorectal cancer depends on its ability to regulate epithelial cell proliferation and gut microbiota in maintaining intestinal homeostasis independently of the effector cytokines. In this review, we will highlight the recent progress on the role of the AIM2 inflammasome as a guardian of cellular integrity in modulating chronic inflammatory diseases, cancer and infection.
AIM2 recognises double‐stranded DNA released during pathogenic assault or host cellular damage, resulting in activation of the AIM2 inflammasome. The AIM2 inflammasome promotes sterile inflammatory diseases such as skin disease, neuronal disease, chronic kidney disease, diabetes and atherosclerosis. However, it is largely protective during infectious diseases and colon cancer.
There is evidence that Janus kinase (JAK)-signal transducer and activator of transcription (STAT) signaling plays a role in the pathogenesis of sarcoidosis. We treated a patient with cutaneous ...sarcoidosis with the JAK inhibitor tofacitinib; the patient had not previously had a response to medications and had not received systemic glucocorticoids. This treatment resulted in clinical and histologic remission of her skin disease. Sequencing of RNA and immunohistochemical examination of skin-lesion samples obtained from the patient before and during therapy and immunohistochemical testing of lesion samples obtained from other patients with cutaneous sarcoidosis support a role for JAK-STAT signaling in cutaneous sarcoidosis. (Funded by the Ranjini and Ajay Poddar Resource Fund for Dermatologic Diseases Research and others.).