Chronic Dermatitis Research Articles

PCR-Based Diagnosis of Leishmania Species in Chronic Granulomatous Dermatitis in Mashhad, Iran.

Cutaneous leishmaniasis (CL) is a chronic granulomatous dermatitis (CGD). Approximately, 90% of CL patients are from seven countries including Iran. We explain polymerase chain reaction (PCR) diagnostic technique for chronic granulomatosis dermatoses including CL in Mashhad, Iran. This study enrolled 64 patients within 2009-2013 with chronic granulomatosis dermatitis referred to dermatology and pathology departments of Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences (MUMS), Mashhad, Iran. We gathered demographic data from archived folders. Histological light microscopic evaluation and parasitological tests were done on selected specimens. We used PCR diagnostic test on specimens. Statistical analysis was done by SPSS version 15. Generally, 7 out of 64 specimens had Leishmania DNA and other samples had no Leishmania DNA. The mean age of patients was 46 ± 18.77 years; disease duration was 7 ± 6.73 months ranging from 1-24 months. Most of the lesions were located on face and upper limb. Totally, 5 out of 7 samples were Leishmania major and 2 out of 7 samples were L. tropica. Tuberculoid granuloma was present in L. tropica samples and 3 of L. major samples. Other light microscopic changes were as follow: 42 suppurative granuloma, and epidermal changes including atrophy, pseudoepitheliomatous hyperplasia, and parakeratosis with dermal changes including, plasma cell, involvement of papillary and reticular dermis, and distribution of granuloma to hypodermis. Our results addressed PCR-based diagnosis of chronic cutaneous leishmaniasis, which is resulted from L. major and L. tropica.

Treatment of palpebral squamous cell carcinoma in a cat using strontium‐90 plesiotherapy

AbstractThe diagnosis, treatment and outcome of palpebral squamous cell carcinoma in a 7‐year‐old, male, neutered domestic shorthair cat is reported, after a 2‐year history of progressive ocular discharge and dermatitis. On presentation, there were multifocal ulcerations and eschars beginning just dorsal to the medial canthus, and extending along the medial canthus to just temporal of the middle of the lower eyelid. A biopsy sample was obtained and consistent with squamous cell carcinoma with mild to moderate chronic, lymphoplasmacytic and mastocytic dermatitis. The cat underwent one session of strontium‐90 plesiotherapy. There were no signs of squamous cell carcinoma recurrence at the time of the last follow‐up examination 4 months after strontium‐90 plesiotherapy. However, alopecia and mild epiphora were still present. This patient had an excellent ocular outcome after strontium‐90 plesiotherapy.

Paeonia × suffruticosa (Moutan Peony)—A Review of the Chemical Composition, Traditional and Professional Use in Medicine, Position in Cosmetics Industries, and Biotechnological Studies

The aim of this review is to perform a systematic review of scientific papers and an in-depth analysis of the latest research related to Paeonia × suffruticosa Andrews as a valuable plant species, important in pharmacy and cosmetology. P. × suffruticosa bark root-Moutan cortex is a medicinal raw material formerly known from traditional Chinese medicine (TCM) but less common in official European medicine. It was introduced for the first time in the European Pharmacopoeia Supplement 9.4 in 2018. In this work, the numerous possible applications of this raw material were depicted based on modern professional pharmacological studies documenting its very valuable medicinal values, including antioxidant, cytoprotective, anti-cancer, anti-inflammatory, cardioprotective, anti-atherosclerotic, anti-diabetic and hepatoprotective activities. The scientific studies indicated that the profile of raw material activity is mainly due to paeonol, paeoniflorin and 1,2,3,4,6-penta-O-galloyl-β-D-glucopyranose. Moreover, the significance of this plant (its different organs) in the production of cosmetics was underlined. P. × suffruticosa finds increasing application in cosmetology due to research on its chronic dermatitis, anti-aging and brightening effects. Furthermore, some biotechnological research has been described aimed at developing effective in vitro micropropagation protocols for P. × suffruticosa.

Systematic review of the prevalence and incidence of the photodermatoses with meta-analysis of the prevalence of polymorphic light eruption.

Information about the prevalence of photodermatoses is lacking, despite their substantial impact on life quality. Our objective was to systematically review the literature to establish what is known regarding prevalence and incidence of photodermatoses. We searched Medline, CINAHL and Embase from inception to 2021 to identify original population-based studies in English literature reporting the prevalence and/or incidence of photodermatoses. Information was extracted according to geographical location and risk of bias was assessed using a 10-point risk of bias tool for prevalence studies. Primary outcome was the population prevalence of photodermatoses. Prevalence data for polymorphic light eruption (PLE) were used to calculate the global pooled prevalence of PLE. Twenty-six studies were included; 15 reported prevalence of photodermatoses based on samples of the general population and 11 on prevalence and/or incidence from national and international registry data. The general population studies involved PLE (nine studies), unspecified photosensitivity (2), actinic prurigo (2), juvenile spring eruption (1), chronic actinic dermatitis (1) and variegate porphyria (1), while registry studies reported on cutaneous porphyrias and genophotodermatoses (nine and two studies, respectively). Worldwide the prevalence of PLE between countries ranged from 0.65% (China) to 21.4% (Ireland). The pooled estimated prevalence of PLE was 10% (95% CI 6%-15%) among the general population (n= 19,287), and PLE prevalence increased with distance from the equator (r= 0.78, p< 0.001). While several photodermatoses are rare, photosensitivity can be prevalent at wide-ranging world locations, including Egypt where photosensitivity was found in 4% of children and 10% of adults. This study showed that PLE is highly prevalent in many populations and that its prevalence shows a highly significant correlation with increasing northerly or southerly latitude. Available population-based studies for photodermatoses suggest they can be prevalent at a range of world locations; more attention is required to this area.

360 TLR4 Plays An Important Role In Chronic Relapsing Pruritus Induced By Subcutaneous Capsaicin Injection In Neonatal Rats

Despite the high prevalence of chronic dermatitis and the accompanied intractable itch, therapeutics that specifically target itching have low efficacy. Although toll-like receptors (TLRs) are suggested to contribute to immune activation and neural sensitization, their roles in chronic itch in the skin remain elusive. Here, we show that the RBL-2H3 mast cell line expresses TLR4 and that treatment with a TLR4 antagonist opposes the LPS-dependent increase in mRNA levels of Th2 and innate cytokines.

Hydrolyzable Tannins in the Management of Th1, Th2 and Th17 Inflammatory-Related Diseases

Plants rich in hydrolyzable tannins were traditionally used all over the world for a variety of chronic inflammatory disorders, including arthritis, colitis, and dermatitis. However, the knowledge of their immunological targets is still limited though fundamental for their rational use in phytotherapy. The recent advances regarding the pathogenesis of inflammatory-based diseases represent an opportunity to elucidate the pharmacological mechanism of plant-derived metabolites with immunomodulatory activity. This review collects recent articles regarding the role of hydrolyzable tannins and their gut metabolites in Th1, Th2, and Th17 inflammatory responses. In line with the traditional use, rheumatoid arthritis (RA), inflammatory bowel diseases (IBDs), psoriasis, atopic dermatitis (AD), and asthma were the most investigated diseases. A substantial body of in vivo studies suggests that, beside innate response, hydrolyzable tannins may reduce the levels of Th-derived cytokines, including IFN-γ, IL-17, and IL-4, following oral administration. The mode of action is multitarget and may involve the impairment of inflammatory transcription factors (NF-κB, NFAT, STAT), enzymes (MAPKs, COX-2, iNOS), and ion channels. However, their potential impact on pathways with renewed interest for inflammation, such as JAK/STAT, or the modulation of the gut microbiota demands dedicate studies.

Recurrent vulval angiomyofibroblastoma; An unusual benign mesenchymal tumour, misdiagnosed

We present a case report of a middle aged post menopausal female with a huge pelvic mass for last 15 years that was previously misdiagnosed as chronic dermatitis. Based on its uncanny appearance, it was decided to do complete excision of the vulval mass to rule out any soft tissue tumour. The histopathology came out to be a rare benign lesion i.e, angiomyofibroblastoma with the immunohistochemistry report favouring the diagnosis. The patient after complete excision is under routine follow up and survelliance and is recurrence free to date.

BARRIERS OF USE OF PROMS AMONG ALLERGISTS WHO TREAT ATOPIC DERMATITIS AND CHRONIC URTICARIA

<h3>Introduction</h3> Patient-reported outcome measures (PROMs) are useful tools for monitoring chronic urticaria (CU) and atopic dermatitis (AD), but at the same time their use present different challenges, so the present study aims to identify the main barriers perceived by allergists treating AD and UC regarding the use of PROMs. <h3>Methods</h3> A cross-sectional study using a web-based survey sent to allergists worldwide. We performed U-Mann-Whitney and binary logistic regression tests using SPSS Statistics to compare the results between the groups, a p<0.05 was considered significant. <h3>Results</h3> We had a total of 546 allergists, 56.6% were female, 13.7% were from Mexico, 13.2% from Russia and 8.8% from Iran. They had a median of 48 years old and a median of 20 years of specialty. The most common barriers were: time constrains, lack of integration into clinical systems and not availability for certain age groups. Logistic regression demonstrated that treating CU was associated with increased odds of "Time Constrains" barrier (OR=0.93; 95% CI = 0.89-0.96, p: 0.001). On the other hand, treating AD increase the odds of the second barrier (OR=1.12; 95% CI = 1.07-1.18, p: 0.000). <h3>Conclusion</h3> Lack of time has been described as one of the biggest barriers to routine PROMs use in the allergy setting. It is imperative to reinforce the dissemination of new tools online or facilitate their integration into clinical systems to reduce the time spent filling out PROMs.

Lipidomics Profile Change of Skin Surface Lipids in Nummular Eczema

Nummular eczema (NE), first introduced by Devegie in 1857, is chronic dermatitis characterized by oval or coin-shaped lesions with distinct boundaries, usually accompanied by severe pruritus (Leung et al., 2020). Although, its pathophysiological characteristics are still scarcely available, various factors have been reported to be implicated such as nutrition, infection, alcohol intake, dry skin, contact irritation and sensitivity (Bonamonte et al., 2012). Besides controlling inflammation, management is aimed at reducing skin dryness and restoring the skin barrier, which improves xerosis and irritation (Leung et al., 2020).

АNXIETY AND DEPRESSION IN PREDICTING THE RISK OF CHRONIC SPONTANEOUS URTICARIA (CSU) AND ATOPIC DERMATITIS (AD)

&nbsp;&nbsp; Previous research has shown that anxiety and depression are associated with many chronic skin diseases, including chronic spontaneous urticaria (CSU) and atopic dermatitis (AD). A causal relationship between these phenomena has not yet been established. Most authors believe that these itchy conditions cause anxiety, depression, and insomnia rather than the other way around. In our work, we attempted to assess the predictive value of anxiety and depression as risk factors for chronic urticaria and atopic dermatitis. We aimed to investigate the impact of depression and anxiety as risk factors for atopic dermatitis and urticaria. We also assessed the predictive value of the logistic regression method in prospective observational clinical trials. The study included 120 patients suffering from chronic spontaneous urticaria and 110 patients with atopic dermatitis registered at the university clinics of TSMU for 2018-2021 years. A comparison of risk concentration in the studied groups was carried out according to the Lorenz curve and by calculating the Gini coefficient. It is concluded that depression and anxiety are considered significant risk factors for developing chronic spontaneous urticaria and, to a lesser extent, atopic dermatitis. The Lorenz curve characterizes the concentration of the risk of morbidity in individuals with the most significant threat. It can be successfully used to predict the development of chronic spontaneous urticaria.

Comparison of Acute and Chronic Toxicities with Daily vs. QOD Partial Breast Radiation Therapy

<h3>Purpose/Objective(s)</h3> Radiation therapy for breast cancer has evolved from standard fractionation over 5-6 weeks to regimens that allow for completion in 1 week or less; additionally, the target of therapy for patients following breast conserving surgery has evolved from whole breast to partial breast for appropriately selected patients. One such regimen is a 5-fraction partial breast approach; while originally given every other day, questions regarding delivery daily have emerged. We therefore aimed to characterize the acute and chronic toxicities of daily or every-other-day (QOD) 5 fraction PBI. <h3>Materials/Methods</h3> The charts of 273 patients treated from 2017-2021 were identified from an institutional registry and retrospectively reviewed to assess for acute (within 90 days of treatment) and chronic toxicities. All patients received 30 Gy in 5 fractions. Their age, BMI, comorbidities, follow up time, tumor stage, adjuvant therapies, and type of toxicity were recorded. Toxicity related to radiation treatment includes fatigue, dermatitis, desquamation, telangiectasia, lymphedema, and cosmesis. Clinical variables were summarized using descriptive statistics and compared using the Chi-square test. <h3>Results</h3> Of the 273 patients, 64 were treated daily with APBI and 209 were treated QOD. Median follow up was 0.8 years in the daily and 1.2 years in the QOD group. With respect to stage, Tis (11% daily, 19% QOD), T1 (86% daily, 76% QOD), and T2 (3% daily, 5.8% QOD) were relatively well balanced between groups. Comorbidities in both groups were comparable and included obesity (p=0.77), COPD (p=1), CAD (p=1), asthma (p=0.79), HTN (p=0.47), diabetes (p=0.49), and dyslipidemia (p=0.38). 1.6% of patients in the daily group and 1.5% patients in the QOD group received HER2 targeted therapy. 1% of patients in the QOD group and no patients in the daily group received anthracycline. 78% of patients in the daily group and 76% of patients in the QOD group were treated with endocrine therapy. Patients who received QOD therapy had higher rates of acute grade 1 dermatitis (34% QOD vs 19% daily, p = 0.02) and grade 1 fatigue (15% QOD vs 6% daily, p = 0.11). Overall, the majority of patients in both groups did not experience any acute fatigue (93.8% daily, 84% QOD). There were very few instances of chronic toxicity overall, only 1 patient (1.7%) in the daily group with chronic dermatitis vs. 7 (3.6%) in the QOD group. 12% of QOD patients experienced chronic toxicities including hyperpigmentation or fibrosis vs. 3.4% from the daily group (p = 0.051). <h3>Conclusion</h3> Overall, there are few acute and chronic toxicities related to 5 fraction APBI, with significantly less acute toxicity among the daily group. Daily APBI treatment can be considered for patients as an alternative to QOD 5 fraction PBI.

Key factors to establish the ovalbumin-induced atopic dermatitis minipig model: age and body weight

BackgroundGiven its similar structure and immune response to the human skin, porcine is a good model for dermal studies. Here, we sensitized ovalbumin (Ova) on minipig back skin for 2–4 weeks to induce chronic atopic dermatitis (AD).ResultsGross observation, serum cytokine level, epidermal thickness, and epidermal integrity did not change after 4 weeks of Ova induction compared with the control, indicating AD modeling failure. Only the neutrophils in the blood and macrophages in bronchoalveolar lavage fluid changed slightly until 3 or 2 weeks after Ova sensitization, respectively. The successful and failed Ova-induced AD minipig models only differ in age and body weight of the minipigs. The minipigs, 12 months old with a 30-kg median weight, had a two-fold thicker dermis than minipigs 8–10 months old, with an 18.97-kg median weight, resulting in impaired Ova permeability and immune response.ConclusionAge and body weight are key factors that should be considered when developing an Ova-induced AD minipig model.

Non-FDA-Approved Uses of Apremilast in Dermatology: A Review of Current Available literature

Introduction: Apremilast, an oral phosphodiesterase-4 inhibitor, decreases the production of pro-inflammatory cytokines including tumour necrosis factor-α, interleukin-12/23, IL-12, IL-2, and interferon-γ; while upregulating the anti-inflammatory cytokine IL-10. Its pan-immunomodulatory nature has led to its use in managing various immune-mediated dermatoses for non-FDA-approved indications. Objectives: To review and analyze the use of Apremilast in Non-FDA-approved indications in current available literature. Materials and methods: PubMed, EMBASE, SCOPUS, and Google scholar databases were searched with the parameters “Apremilast”, “Apremilast NOT Psoriasis*”, “Apremilast NOT Behçet’s*”, and “Apremilast NOT arthritis*”. A total of 45 relevant articles were chosen for review. Results: We found 22 indications in dermatology where apremilast has been used without FDA approval. The best evidence was for treatment in Atopic Dermatitis, Alopecia Areata, and Hidradenitis Suppurativa, with randomized controlled trials. Prospective open-label trials were found for Cutaneous Sarcoidosis, Lichen Planus, Rosacea, and Vitiligo. Individual case series and reports were found for Acrodermatitis Continua of Hallopeau, Dermatomyositis, Disseminated Granuloma Annulare, Erythema Nodosum Leprosum, Morphea, Pityriasis Rubra Pilaris, Hailey-Hailey Disease, Recurrent Erythema Multiforme, and Folliculitis Decalvans, Prurigo Nodularis, Perforating Dermatoses, Chronic Actinic Dermatitis, and Hand Eczema, and Epidermolysis Bullosa Simplex-Generalised Severe Type. Apremilast has shown varied efficacy despite a better safety profile and tolerability over a long duration compared to conventional immunosuppressant drugs and placebo. Conclusion: Apremilast has been used for varied non-FDA-approved indications in dermatology with variable efficacy. Better controlled, randomized studies with adequate sample size and drug comparisons are needed for better analyses.

S2.4a Pythiosis: An emerging disease in Hong Kong

S2.4 Veterinary mycology research, September 21, 2022, 3:00 PM - 4:30 PMOomycosis is an emerging disease of humans and animals caused by oomycetes in the Stramenopiles-Alveolata-Rhizaria super group, mainly Pythium insidiosum and occasionally Lagenidium giganteum or Paralagenidum species. In surface freshwater, oomycetes produce motile biflagellate asexual zoospores with marked chemotactic attraction to epithelial surfaces of vertebrate hosts. Infection is the result of encystation and invasion of damaged skin or gastrointestinal mucosa.Of ∼ 4200 cases of pythiosis reported globally between 1980 and 2021 only ∼ 20% involved humans while 80% involved animals, mainly horses, dogs, and cattle. Most human cases occur in India and Thailand, whereas most animal infections were reported in the United States and Brazil. Pythiosis has been reported in mainland China, but the burden of the disease is low and comprises <1% of overall cases in humans.Neither pythiosis nor lagenidiosis has been previously reported in humans or animals in Hong Kong. From January 2018 to January 2022, the Veterinary Diagnostic Laboratory of City University of Hong Kong diagnosed 10 cases of oomycosis (5 canine, 5 feline) after identification of non-parallel walled, irregularly branching, and poorly septate hyphae in the center of necrotic regions of histological sections of formalin-fixed paraffin-embedded tissues (FFPET). Species identity was confirmed by PCR and sequencing of 28S rDNA from DNA extracts of FFPET. There were 8 cases of P. insidiosum and 2 of L. giganteum infection. Serum ELISA was positive for Pythium antibodies in 5/6 cases tested and negative for Pythium/Lagenidium/Paralagenidum antibodies in a German shepherd dog (GSD) with disseminated disease caused by L. giganteum.Affected dogs were young to middle-aged at presentation (9 months to 5 years old). Two dogs had focal cutaneous infections, two had extensive gastrointestinal involvement, and the GSD had disseminated disease with cutaneous, mediastinal, and abdominal involvement.Affected cats were young (8 weeks to 18 months) and presented with subcutaneous/cutaneous disease. Three cats had a distinctive perianal ring of bulging subcutaneous granulation tissue, including one that also had an ulcerated, proliferative and necrotic lesion involving two adjacent hind-limb digits. One cat had facial subcutaneous swelling with mandibular lymph node enlargement and the remaining cat presented with extensive circumferential swelling of one hind limb from the distal paw to the mid-stifle.All cats tested negative for the Feline leukemia virus and Feline immunodeficiency virus. Traumatic or surgical wounds preceding infection were identified in a kitten caught in a rodent glue-trap with skin wounds, in a cat with facial involvement that had an injured globe surgically enucleated, and in a dog with cutaneous pythiosis that had chronic dermatitis.Treatment data were available for one canine case. The GSD with lagenidiosis was treated with combination antimicrobial therapy including voriconazole, terbinafine, minocycline, and azithromycin. The dog responded poorly. Mefenoxam was substituted for voriconazole and hyperbaric oxygen therapy was administered. After initial response, the dog succumbed 4 months from diagnosis. We have had success with the treatment of four feline cases using combination therapy including surgical debridement, immunotherapy with a Pythium vaccine, and combinations of antifungal drugs (posaconazole and terbinafine), and/or antimicrobials (doxycycline/minocycline and azithromycin).

Chronic actinic dermatitis: A 5-year clinical analysis of 488 patients in China.

Chronic actinic dermatitis (CAD) is a spectrum of diseases with chronic photosensitivity occurring mostly among middle-aged and older men. We seek to explore the characteristics and pathogenesis of CAD among the Chinese population. The medical records of 488 CAD cases diagnosed by phototesting at Huashan Hospital, Fudan University from January 2014 to December 2018 were analyzed retrospectively. Among the 488 patients, 344 were male and 144 were female. 84.8% of the cases were over 40 years old at the age of onset, while the remaining with an early age of onset had a prevalence of atopic history of 21.6%. Up to 45.0% of the patients reported excessive sun exposure and outdoor activities before the initiation of symptoms. The typical skin lesions were erythema, papules and plaques laid predominantly in sun-exposed areas. 42.8% of the cases showed sensitivity to UVB only, 20.7% were both sensitive to UVA and UVB, and 18.2% had UVA sensitivity only. The most predominant photoallergens were chlorpromazine (80.1%), thimerosal (17.2%), potassium dichromate (12.7%), etc. The most prevalent patch test allergens were potassium dichromate (24.4%), thimerosal (20.5%), formaldehyde (16.8%), etc. CONCLUSIONS: CAD was more commonly seen in males over 40 years old. The action spectrum of Chinese patients is primarily in the UVB range. Exposure to excessive sunlight or contact allergens and photoallergens are important risk factors. Photobiology tests are essential in detecting photosensitivity and recognizing potential photosensitizers. Early avoidance of confirmed photoallergens and sun exposure may prevent photosensitive reactions from progressing into persistent photosensitivity.

Curcumin Improves Keratinocyte Proliferation, Inflammation, and Oxidative Stress through Mediating the SPAG5/FOXM1 Axis in an In Vitro Model of Actinic Dermatitis by Ultraviolet.

Background Chronic actinic dermatitis (CAD) is an abnormally proliferating photoallergic skin disease. Dysregulated inflammation and oxidative stress are the immediate factors in the abnormal proliferation of keratinocytes. This study aimed to investigate the effect of curcumin on the aberrant proliferation of keratinocytes in an in vitro (actinic dermatitis) AD model and the possible molecular mechanisms. Methods The keratinocytes were irradiated with ultraviolet (UV) to construct an in vitro AD model and then processed with different concentrations of curcumin. Cell viability, oxidative stress markers (SOD, GSH-PX, and MDA), activated oxygen species (ROS), and inflammation markers (IL-1β, IL-6, IL-18, and TNFα) were determined, respectively. Western blot was applied to assay the profiles of apoptosis-related proteins (Bax, Bcl-xL, Caspase3, Caspase8, and Caspase9), oxidative stress proteins (Keap1, Nrf2, HO-1, COX2, and iNOS), and inflammatory proteins (NF-κB, MMP1, and MMP9) and SPAG5/FOXM1. Functionally, SPAG5 or FOXM1 overexpression and knockdown models were constructed in keratinocytes to characterize their influence on UV irradiation-mediated keratinocyte dysfunction. Results Curcumin weakened UV-mediated inflammation, proliferation, and oxidative stress and impaired apoptosis in keratinocytes. UV boosted SPAG5/FOXM1 expression in cells, while curcumin concentration-dependently retarded SPAG5/FOXM1 expression. Overexpression of SPAG5/FOXM1 fostered UV-mediated inflammation, proliferation, oxidative stress, and intensified apoptosis, whereas curcumin mostly reversed the SPAG5/FOXM1-mediated effects. In addition, knocking down SPAG5/FOXM1 ameliorated UV-mediated keratinocyte dysfunction, whereas curcumin failed to exert further protective effects in cells with knockdown of SPAG5/FOXM1. Conclusion Curcumin modulated proliferation, inflammation, oxidative stress, and apoptosis of keratinocytes by restraining the SPAG5/FOXM1 axis.

Transcriptomic, Epigenomic, and Neuroanatomic Signatures Differ in Chronic Prurigo, Atopic Dermatitis, and Brachioradial Pruritus

Scratching and scratch-induced injuries, including neuroanatomical alterations, are key characteristics of chronic pruritus entities of different origins. The aim of this study was to link gene expression (array hybridization, qPCR) with DNA methylation (array hybridization) and neuroanatomy (PGP9.5 staining) in chronic nodular prurigo (CNPG), atopic dermatitis (AD), brachioradial pruritus (BRP), and matched healthy controls. Specific signatures of gene expression and DNA methylation clearly discriminated pruritic lesional skin from nonpruritic skin in CNPG and from healthy skin of volunteers, respectively. Although intraepidermal nerve fiber density was indiscriminately reduced, the level of epidermal branching, assessed by a semiquantitative pattern analysis, differentiated the entities (CNPG > BRP > AD). Correspondingly, repellent SEMA3A showed the highest expression in AD, whereas axonal growth-promoting nerve GF was most prominent in CNPG and BRP. Overexpression of genes for nerve fiber regeneration (NELL2/NFKB/ARTN) was found in AD and CNPG but not in BRP. Our findings suggest that differential branching patterns rather than mere innervation density separate chronic itch conditions and reflect disease-specific local expression profiles. In pruritic dermatoses (AD and CNPG), nerve injury and subsequent sprouting may primarily result from chronic scratching, whereas genuine neuropathy is expected to underlie BRP.

Genital Examination of the Prepubertal Female: Essentials for Pediatric Nurse Practitioners.

Genital Examination of the Prepubertal Female: Essentials for Pediatric Nurse Practitioners.

33142 Efficacy and safety of apremilast for the treatment of Japanese patients with palmoplantar pustulosis: Results from a phase 2, randomized, placebo-controlled study

Background: Palmoplantar pustulosis (PPP) is a pruritic, painful chronic dermatitis, and approved therapeutic options are limited. This randomized, phase 2 study (NCT04057937) evaluated apremilast 30 mg BID (APR) efficacy and safety vs placebo (PBO) for moderate to severe PPP after inadequate response to topical therapy in Japan.

IL-25 contributes to development of chronic contact dermatitis in C57BL/6 mice, but not BALB/c mice

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by type 2 immune responses. Interleukin-25 (IL-25) is produced predominantly by epithelial cells. It can activate Th2 cells to produce type 2 cytokines such as IL-4, IL-5 and IL-13, contributing to host defense against nematodes. However, excessive/inappropriate production of IL-25 is considered to be involved in development of type 2 cytokine-associated allergic disorders such as asthma. On the other hand, the contribution of IL-25 to the pathogenesis of AD remains poorly understood. In the present study, we found that expression of Il25 mRNA was significantly increased in the skin of mice during oxazolone-induced chronic contact hypersensitivity (CHS), which is a mouse model of human AD. In addition, development of oxazolone-induced chronic CHS was significantly reduced in IL-25-deficient (Il25−/−) mice compared with wild-type mice on the C57BL/6, but not BALB/c, background, although IL-25 was not essential for IL-4 production by hapten-specific T cells. Therefore, IL-25 is crucial for development of chronic CHS, although that is partly dependent on the genetic background of the mice.