Background
Autoimmune processes are considered to play a major role in the pathogenesis of chronic spontaneous urticaria (CSU). Very recently, interleukin 24 (IL‐24) has been identified as an ...immunoglobulin E (IgE) autoantigen in CSU. Some studies revealed that notably autologous serum skin test (ASST)‐positive CSU patients may benefit from autohemotherapy; however, the mechanisms of action remain unknown. We aimed to investigate the immunological effects of autologous serum injections in ASST‐positive CSU patients.
Methods
Sixty‐six ASST‐positive CSU patients were treated with weekly intramuscular autologous serum injections for 8 weeks and followed up for 12 weeks. Urticaria activity score (UAS7) and Dermatology Life Quality Index (DLQI) were assessed. The ASST was done at baseline, week 9 and week 21. Serum samples (baseline, weeks 9, 13 and/or 21) were analysed for the levels of IgE‐anti‐IL‐24 and immunoglobulin G (IgG)‐anti‐IL‐24 via ELISA and their ability to release histamine in basophils basophil histamine release assay (BHRA).
Results
Autologous serum therapy resulted in a substantial improvement in disease activity and quality of life after 8 and 20 weeks. Twenty‐eight percent and 34% of patients turned ASST‐negative in weeks 9 and 21, respectively, but there was no link between their response to treatment and changes of ASST results. Also, no significant or relevant changes in BHRA were observed. In contrast, autologous serum therapy significantly decreased IgE‐anti‐IL‐24 serum levels, but not IgG‐anti‐IL‐24 serum levels, in responders but not in non‐responders.
Conclusions
Our findings suggest that the immunological effects of autologous serum therapy include a reduction in IgE‐anti‐IL24 autoantibodies, which may contribute to the pathogenesis of CSU.
Background
Nail changes due to systemic drugs are common, especially with anticancer treatments due to involvement of nail plate, nail bed and periungual area.
Objective
To study the pattern of nail ...changes occurring due to chemotherapy in patients suffering from various malignancies.
Materials and Methods
A prospective, observational study was conducted at various health care centres, Nashik, India, for 15 months. The timing of administration of chemotherapy and onset of nail changes were recorded and evaluated by a dermatologist at regular interval.
Results
A total of 129 diagnosed cases of various malignancies who received chemotherapy were included. The most common malignancy noted was breast cancer, that is n = 42 (32.5%) followed by oral cancer, that is n = 24 (18.6%). Chemotherapy agents included taxanes (n = 54), cyclophosphamide (n = 42) and prednisolone (n = 28). Nail changes were noted in 92 patients (71.3%). The most common nail changes observed were chromonychia (n = 70, 54.26%), followed by nail dystrophy (n = 38, 29.45%).
Conclusion
Nail toxicity is quite common side effect of anticancer agents. Nail changes due to chemotherapy depend on the nail structure involved and the severity of insult. Awareness among dermatologists and oncologists of these nail changes and their culprit agent can promote early diagnosis and may avoid inadvertent measures.
Skin manifestations of COVID‐19 in children: Part 2 Andina, D.; Belloni‐Fortina, A.; Bodemer, C. ...
Clinical and experimental dermatology,
April 2021, 2021-Apr, 2021-04-00, 20210401, 2021-04, Letnik:
46, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Summary
The current COVID‐19 pandemic is caused by the SARS‐CoV‐2 coronavirus. The initial recognized symptoms were respiratory, sometimes culminating in severe respiratory distress requiring ...ventilation, and causing death in a percentage of those infected. As time has passed, other symptoms have been recognized. The initial reports of cutaneous manifestations were from Italian dermatologists, probably because Italy was the first European country to be heavily affected by the pandemic. The overall clinical presentation, course and outcome of SARS‐CoV‐2 infection in children differ from those in adults, as do the cutaneous manifestations of childhood. In this review, we summarize the current knowledge on the cutaneous manifestations of COVID‐19 in children after thorough and critical review of articles published in the literature and from the personal experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discussed one of the first and most widespread cutaneous manifestations of COVID‐19, chilblain‐like lesions. In this part of the review, we describe other manifestations, including erythema multiforme, urticaria and Kawasaki disease‐like inflammatory multisystemic syndrome. In Part 3, we discuss the histological findings of COVID‐19 manifestations, and the testing and management of infected children for both COVID‐19 and any other pre‐existing conditions.
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Many clinical trials have been conducted on the treatment of pityriasis rosea (PR). Our aim was to establish a position statement for the management of adults with PR based on the best available ...evidence. We searched PubMed for all reports on randomized controlled trials for the treatment of PR published in the past 30 years. We retrieved 14 articles reporting randomized controlled trials, and found five which met our quality requirements for in‐depth analyses. Erythromycin was found in a well‐conducted triple‐blind study to cast significant impacts on clinical outcomes. However, adverse gastrointestinal effects were fairly common. Another well‐conducted study on azithromycin reported no significant benefit. It was reported in three well‐conducted studies on oral acyclovir in low dose (400 mg three times daily for 7 days or 400 mg five times daily for 7 days) and high dose (800 mg five times daily for 7 days), that acyclovir is effective in attaining rash regression and lessening the pruritus. When compared against each other, the high‐dose regimen demonstrated no benefit over the low‐dose regimens. Our statement comprises the follows: (i) The diagnosis of PR should be ascertained; (ii) The patients should be assessed for rash severity and impacts on quality of life; (iii) PR is a self‐limiting disease, and most patients do not necessitate any treatment; (iv) For patients necessitating active treatment, oral acyclovir as 400 mg three times daily for 7 days can be considered; (v) Attention should be given to adverse effects and contraindications of acyclovir; (vi) When PR occurs in early pregnancy, oral antiviral therapy could be considered after consulting experienced clinicians; (vii) Inadequate information exists in the use of acyclovir to treatment PR in children and breastfeeding women; and (viii) Treating PR is an off‐label use of acyclovir, and this has to be discussed with experienced colleagues and the patients.
Summary
The current COVID‐19 pandemic is caused by the SARS‐CoV‐2 coronavirus. The initial recognized symptoms were respiratory, sometimes culminating in severe respiratory distress requiring ...ventilation, and causing death in a percentage of those infected. As time has passed, other symptoms have been recognized. The initial reports of cutaneous manifestations were from Italian dermatologists, probably because Italy was the first European country to be heavily affected by the pandemic. The overall clinical presentation, course and outcome of SARS‐CoV‐2 infection in children differ from those in adults as do the cutaneous manifestations of childhood. In this review, we summarize the current knowledge on the cutaneous manifestations of COVID‐19 in children after thorough and critical review of articles published in the literature and from the personal experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discuss one of the first and most widespread cutaneous manifestation of COVID‐19, chilblain‐like lesions. In Part 2, we review other manifestations, including erythema multiforme, urticaria and Kawasaki disease‐like inflammatory multisystemic syndrome, while in Part 3, we discuss the histological findings of COVID‐19 manifestations, and the testing and management of infected children, for both COVID‐19 and any other pre‐existing conditions.
Click here for the corresponding questions to this CME article.
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