Inflammatory Dermatologic Diseases Research Articles

New-Onset Hidradenitis Suppurativa in Psoriasis Patients: A Multi-Center, Retrospective Cohort Study.

Previous research has indicated a potential correlation between hidradenitis suppurativa (HS) and psoriasis (PSO), two chronic inflammatory dermatological diseases. However, there is a lack of comprehensive evaluations that consider a variety of clinical and demographic factors, and the risk of developing HS in PSO patients remains unclear. Our study aims to examine HS risk over time among PSO patients versus matched controls while considering the influence of confounders to provide insights into the potential link between these two diseases. In this multi-institutional cohort study using the TriNetX database, we matched 202,318 patients with PSO with an equivalent number of individuals without PSO, using propensity score matching. The study period extended from 1 January 2005 to 31 December 2018. We computed hazard ratios and their respective 95% confidence intervals (CIs) to evaluate the probability of HS manifestation over a period of 5 years in patients with PSO in comparison to those without PSO. PSO patients demonstrated a consistently higher risk of developing HS than matched controls across all analytic models with the hazard ratios (HR) ranging from 1.43 (95% CI 1.30-1.56) to 5.91 (95% CI 2.49-14.04). Stratified analyses showed the increased HS risk was observed in both genders but only significant in those aged 18-64 years. Kaplan-Meier analysis indicated PSO patients had a higher cumulative probability of developing HS over time (HR 1.77, 95% CI 1.49-1.89). PSO was associated with increased HS risk, highlighting the importance of considering HS as a potential comorbidity in PSO patients and may have implications for early detection, prevention, and management strategies for both conditions. Shared inflammatory pathways, genetic components, and skin dysbiosis may contribute. Further research should elucidate underlying mechanisms.

Genome‑wide association study and polygenic risk scores predict psoriasis and its shared phenotypes in Taiwan.

Psoriasis is a chronic inflammatory dermatological disease, and there is a lack of understanding of the genetic factors involved in psoriasis in Taiwan. To establish associations between genetic variations and psoriasis, a genome‑wide association study was performed in a cohort of 2,248 individuals with psoriasis and 67,440 individuals without psoriasis. Using the ingenuity pathway analysis software, biological networks were constructed. Human leukocyte antigen (HLA) diplotypes and haplotypes were analyzed using Attribute Bagging (HIBAG)‑R software and chi‑square analysis. The present study aimed to assess the potential risks associated with psoriasis using a polygenic risk score (PRS) analysis. The genetic association between single nucleotide polymorphisms (SNPs) in psoriasis and various human diseases was assessed by phenome‑wide association study. METAL software was used to analyze datasets from China Medical University Hospital (CMUH) and BioBank Japan (BBJ). The results of the present study revealed 8,585 SNPs with a significance threshold of P<5x10‑8, located within 153 genes strongly associated with the psoriasis phenotype, particularly on chromosomes 5 and 6. This specific genomic region has been identified by analyzing the biological networks associated with numerous pathways, including immune responses and inflammatory signaling. HLA genotype analysis indicated a strong association between HLA‑A*02:07 and HLA‑C*06:02 in a Taiwanese population. Based on our PRS analysis, the risk of psoriasis associated with the SNPs identified in the present study was quantified. These SNPs are associated with various dermatological, circulatory, endocrine, metabolic, musculoskeletal, hematopoietic and infectious diseases. The meta‑analysis results indicated successful replication of a study conducted on psoriasis in the BBJ. Several genetic loci are significantly associated with susceptibility to psoriasis in Taiwanese individuals. The present study contributes to our understanding of the genetic determinants that play a role in susceptibility to psoriasis. Furthermore, it provides valuable insights into the underlying etiology of psoriasis in the Taiwanese community.

Estimation of health utility values for alopecia areata

PurposeAlopecia areata (AA) is an autoimmune-mediated inflammatory dermatological disease characterised by non-scarring hair loss affecting the scalp and sometimes other hair-bearing sites. This study aimed to elicit health state utility values (HSUVs) from the UK general population for AA using time trade off (TTO) interviews.MethodsVignette descriptions of health states defined by the extent of hair loss were developed (as well as one describing caregiver burden). These were developed using data from standardised patient reported outcome (PRO) measures, a literature review and qualitative interviews. Health states were defined based on the severity of alopecia tool (SALT), which assesses extensiveness of scalp hair loss. HSUVs were then elicited for each health state in TTO interviews with the UK public.ResultsOne caregiver and five patient health states were developed based on the literature review findings, clinical trial PRO (Hospital Anxiety and Depression Scale and Alopecia Areata Patient Priority Outcomes Questionnaire) data and qualitative interviews with patients (N = 11), clinical experts (N = 4) and caregivers of adolescents with AA (N = 10). These data showed a more severe impact among patients with more extensive hair loss. One hundred and twenty participants evaluated the vignettes in TTO interviews. Patient HSUVs ranged from 0.502 for the most extensive hair loss health state (SALT 50–100 + eyebrow and eyelash loss) to 0.919 (SALT 0–10) for the mildest health state. The caregiver HSUV was 0.882.ConclusionQuantitative and qualitative data sources were used to develop and validate vignettes describing different AA health states. Patient and caregiver HSUVs demonstrate a large impact associated with AA, especially for states defined by more extensive hair loss.

Saliva: An Emerging Adjunct Biomarker for Psoriasis –Trends, Scope and Relevance

Psoriasis is a widely prevalent chronic immuno inflammatory dermatological disease resulting from a complex and dynamic interplay of genetic, environmental, and immunological aetiologies. It manifests as characteristic erythematous psoriatic plaques visible to the naked eye, but prognostic biomarkers for disease monitoring and therapeutic effectiveness are still absent. Saliva is a biological fluid that, besides being critical to maintaining oral homeostasis, harbors various salivary microbiota and inflammatory markers. It can be easily collected, stored, and analyzed. Oral fluids offer an excellent advantage for biomarker study as they are non-invasive and fast techniques. Studies showed that the saliva of healthy individuals and those with psoriasis had differences in the levels of inflammatory cytokines, immunoglobulin A, and anti-oxidant biomarkers. In GCF, individuals with psoriasis showed higher levels of S100A8, IL-18, and sE-selectin than healthy individuals, independent of periodontal status. Oxidative stress(OS) is one of the pathogenetic factors of psoriasis. Thus levels of ROS and anti-oxidants can also become important factors in diagnosis.

Knowledge, Attitude, and Practice Regarding the Use of Isotretinoin in Saudi Arabia.

Background Acne vulgaris is a widespread chronic inflammatory dermatological disease with a worldwide prevalence of 9.4%, affecting a large percentage of the young population in the Kingdom of Saudi Arabia. This study aimed to measure the knowledge, attitude, and practice toward the use of isotretinoin among the Saudi population. Methodology This cross-sectional study was conducted among the general population in Saudi Arabia between April 2023 and July 2023. A self-administered questionnaire was distributed across five regions of Saudi Arabia (central, eastern, western, southern, and northern) using Google Survey. The questionnaire included sociodemographic data, the pattern of isotretinoin used, and a 24-item questionnaire to assess the knowledge about isotretinoin. Results Of the 3,001 participants, 77.1% were females, and 55.4% were aged between 16 and 25 years. The prevalence of participants who previously used isotretinoin was 30.6%. The total mean knowledge score was 10.4 (SD = 5.99) out of 24 points, with more than half (52.9%) considered to have poor knowledge, 39.1% moderate knowledge, and only 7.9% good knowledge. Younger participants, female gender, Saudi nationality, never been married, and previous use of isotretinoin were associated with increased knowledge. Conclusions The knowledge of the general population regarding isotretinoin use was lacking. However, younger Saudi females who had previous isotretinoin usage tended to be more knowledgeable about isotretinoin compared to the rest of the participants. Increasing the general public's knowledge regarding isotretinoin and its safe use is necessary.

(028) A Comparison of Genital Self-Image and Sexual Functioning among Women with Vulvar and Non-Vulvar Dermatologic Disease

Abstract Introduction Inflammatory dermatologic diseases of the vulva represent a significant morbidity burden for affected women. Genital itching, pain, and skin changes have a profound impact on sexual function. Research also suggests women with generalized, non-vulvar dermatologic diseases have impaired sexual function. The Female Genital Self-Image Scale (FGSIS) was developed and validated in a large sample of American women a decade ago. Despite developers’ suggestion that the FGSIS could be used to further understand the burden of genital disease, there remains a paucity of research in this area. Both vulvar and non-vulvar inflammatory skin disease have yet to be fully characterized with regards to impact on genital self-image (GSI), a key mediator in sexual health and behavior. Objectives The present study describes GSI, sexual function, and sexual behaviors among women with vulvar and non-vulvar inflammatory dermatoses. Methods A 20-minute Qualtrics survey was distributed between September and November 2020 through three primary means: 1) targeted social media ads, 2) relevant social media support groups, and 3) online research volunteer recruitment services. Women in the US over age 18 who have ever been diagnosed with an inflammatory dermatosis persisting longer than one month were eligible to participate. The present data were collected as part of a larger study examining sexual health, quality of life, and health care experiences of women with skin disease. Survey items analyzed included the FGSIS, the Female Sexual Function Index (FSFI), and sexual behavior histories. Results The sample consisted of 320 women with a mean age of 42.7±15.5 (Range=19-81). Most participants were pre-menopausal (n=200; 62.5%), Caucasian (n=278; 86.9%), and heterosexual (n=263; 82.2%). Nearly one-third of women (n=98; 30.6%) reported inflammatory dermatologic disease isolated to the vulva, while 150 (46.9%) had strictly non-vulvar disease, and 72 (22.5%) experienced both vulvar and non-vulvar manifestations. The average FGSIS score among women with any vulvar disease was 16.9±4.1 (range=7-28) and was significantly (p&amp;lt;.01) lower than that of women with non-vulvar disease (M=21.2±4.3; range=9-28), with a higher score indicating a more positive FGSIS. A similar trend was seen with the FSFI, which was significantly (p&amp;lt;.01) different among women with vulvar disease (M=15.4±9.7, range=2.0-35.1) compared to women with non-vulvar disease (M=21.2±10.1, range=2.0-35.1), with higher scores indicating better functioning. When stratified by category, FSFI remained significant for desire (p=.04) and pain (p&amp;lt;.01), but not for arousal, lubrication, orgasm, or satisfaction. Women with vulvar disease were significantly less likely to receive (p=.02) or give (p=.04) oral sex or to engage in vaginal intercourse (p&amp;lt;.01) during the last four weeks. Conclusions This study demonstrates severe sexual health morbidity associated with inflammatory vulvar dermatoses, characterized by very low FGSIS and FSFI scores. Pain and desire shaped sexual function for women with vulvar disease, despite non-significant differences in other domains including satisfaction. Results also indicated low FSFI scores in women with non-vulvar disease, with FGSIS scores similar to previously-described healthy controls. A more precise understanding of the role of GSI in both vulvar and non-vulvar disease will provide opportunities for improved patient-centered disease management in the realm of sexual health. Disclosure No.

H13 Leprosy and psoriasis: a heated controversy

Abstract In the Old Testament, the term ‘Lepra’ was used to describe many skin diseases, including psoriasis, eczema, vitiligo, alopecia areata and boils. The word ‘leprosy’ was derived from this and was previously used as a generic term that included multiple inflammatory dermatological diseases. It was a disorder of great religious significance during ancient times, with intense stigmatization—‘lepers’ were pronounced unclean by priests. Hippocrates (460–377 Bc), the Greek ‘father of medicine’, can be credited with being the first to separate medicine from religious superstition. However, there was little differentiation between leprosy and psoriasis, two distinct diseases we know today. He used the word ‘psora’ to describe itch, and ‘lopoi’ to describe the dry and scaly features of skin conditions, thus continuing the confusion between leprosy and psoriasis. The failure to differentiate psoriasis as its own clinical entity from leprosy meant that for many centuries, patients with psoriasis also suffered the same cruel fate as those with leprosy in society. Those suffering from leprosy were wrongly believed to be highly contagious and were forced to carry a bell or clapper to announce their approach to those who were considered healthy. They were required to wear distinctive clothing so that they were easy to recognize by the public, and were not permitted to talk to or even touch a healthy person. They were outcast in society and could only mix with other ‘lepers’. In 1313, Philip the Fair of France horrifically ordered all those outcasts to be burned at the stake. In 1809, Robert Willan (1757–1812), an English doctor, marvellously developed a simple classification of skin diseases that offered a clear description of the different types of psoriasis. This was a crucial milestone in the recognition of psoriasis as a separate skin disease from leprosy. However, while he was the first person to describe psoriasis as a separate condition, he failed to eliminate leprosy completely as an associated disease. He used the term ‘lepra vulgaris’ to discuss modern psoriasis, which once again further perpetuated the confusion between psoriasis and leprosy. Ultimately, it was Ferdinand von Hebra (1816–1880), an Austrian physician, who permanently shed the term ‘lepra’ from the description of psoriasis in the 1800s, finally allowing the two diseases to be separate.

The Impact of COVID-19 Vaccination on Inflammatory Skin Disorders and Other Cutaneous Diseases: A Review of the Published Literature

Background: Four vaccines have been authorized by the European Medicines Agency (EMA): viral vector-based vaccines (AstraZeneca; AZD1222 and Johnson &amp; Johnson; Ad26.COV2. and 2 mRNA-based vaccines (Pfizer/BioNTech; BNT162b2 and Moderna; mRNA-1273). Adverse events (AEs) related to vaccination have been described in the literature. The main aim of the dermatological practice was to avoid the diffusion of COVID-19, allowing the continuity of care for patients. Objective: The aim of this review article is to investigate current literature regarding cutaneous reactions following COVID-19 vaccination, mainly inflammatory dermatological diseases. Materials and methods: Investigated manuscripts included metanalyses, reviews, letters to the editor, real-life studies, case series, and reports. Results: We selected a total of 234 articles involving more than 550 patients. We have divided the results section into various sub-sections to ensure greater understanding for readers. Conclusions: Clinicians should keep in mind the possibility of new onsets or the worsening of several dermatoses following vaccination in order to promptly recognize and treat these AEs. Certainly, vaccination should not be discouraged.

Scarring and Dyschromias in Fitzpatrick Skin Type IV-VI: A Review of Dermatologic Treatment Protocols.

Managing chronic conditions is an essential aspect of dermatologic care, especially regarding the resolution of inflammatory dermatologic disease and recovery of skin lesions. Short-term complications of healing include infection, edema, dehiscence, hematoma formation, and tissue necrosis. At the same time, longer-term sequelae may consist of scarring and scar widening, hypertrophic scars, keloids, and pigmentary changes. This review will focus on dermatologic complications of chronic wound healing in patients with Fitzpatrick skin type (FPS) IV-VI or skin of color (SOC), with an emphasis on hypertrophy/scarring and dyschromias. It will focus on current treatment protocols and the potential complications specific to patients with FPS IV-VI. There are multiple complications of wound healing that are more prevalent in SOC, including dyschromias and hypertrophic scarring. These complications are challenging to treat, and current protocols are not without complications and side effects that must be considered when offering therapy to patients with FPS IV-VI. When treating pigmentary and scarring disorders in patients with skin types FPS IV-VI, it is essential to implement a stepwise approach to management that is conscious of the side effect profile of current interventions. J Drugs Dermatol. 2023;22(7): doi:10.36849/JDD.7253.

Abrocitinib: A panacea for atopic dermatitis

Atopic Dermatitis [AD] is a chronic relapsing inflammatory dermatological disease characterized by itch, dry skin, localized or disseminated eczematous lesions and hyperpigmentation of skin. There are several exogeneous and endogenous risk factors for development of AD. The endogenous factors include genetic factors, atopy, skin hyperreactivity and exogeneous factors such as food, dust, pollen, epidermal, fungal, bacterial, and vaccine-associated factors. The management of AD includes topical treatments such as topical corticosteroids, topical capsaicin, topical calcineurin inhibitors and phosphodiesterase inhibitors. Systemic therapies such as corticosteroids, immunosuppressants, biologicals, gabapentinoids and antidepressants are provided to patients with inadequate systemic therapies have wide range of side effects limiting their use in many patients. Therefore, there is a need for innovative treatment options. This led to development of Janus kinase inhibitors. First generation JAK inhibitors includes Tofacitinib, Baricitinib, Ruxolitinib, Oclacitinib. Second generation drugs such as Upadacitinib and Abrocitinib are more specific towards the JAK isoforms. This review addresses the importance of Abrocitinb for the treatment of Atopic Dermatitis. Abrocitinib an oral once daily treatment for moderate to severe atopic dermatitis developed by Pfizer. Studies shows that Abrocitinib is better alternative in non- responders to Dupilumab therapy or patients with contraindications to the Dupilumab. The patient’s adherence to medication will also be better with oral route rather than injections. Abrocitinib will be widely accepted because of its clinical benefits such as reduction in itching and more convenient oral route of administration.

Granuloma faciale in a patient with remitting seronegative symmetric synovitis with pitting edema.

Granuloma faciale (GF) is a rare benign chronic inflammatory dermatologic disease which is characterized by facial lesions. The diagnosis is mainly based on clinical and histopathology findings. It may be resistant to treatments and prone to relapse. Different treatment modalities include corticosteroid therapy, tacrolimus, cryotherapy and surgical methods. We report a case of GF in a patient with remitting seronegative symmetric synovitis with pitting edema (RS3PE). A male patient with RS3PE presented with reddish brown soft nodules on and over lateral aspects of his nose and adjacent areas on his face which were diagnosed histologically as GF. He was treated with prednisolone, methotrexate and clobetasol propionate cream successfully without recurrence. To the best of our knowledge this is the first case report of GF occurring in a patient with RS3PE.

Effect of low-calorie diet on psoriasis severity index, triglycerides, liver enzymes, and quality of life in psoriatic patients with non-alcoholic fatty liver disease.

Chronic-plaque psoriasis is a chronic inflammatory dermatological disease. Obesity comorbidities, including non-alcoholic fatty liver disease, are highly prevalent in patients with chronic-plaque psoriasis. Recently, weight loss has been a highly recommended intervention to improve the severity of psoriatic symptoms, psoriasis-induced chronic systemic inflammation, psoriasis-associated cardiovascular risk factors, quality of life, and the efficacy of anti-psoriatic drugs. This study was designed to assess the effect of a 12-week low-calorie-diet intervention on aspartate transaminase, psoriasis severity (assessed via Psoriasis Area and Severity Index - PASI), alanine transaminase, quality of life (assessed via Dermatology Life Quality Index - DLQI), triglycerides, waist circumference (WC), and body mass index (BMI) in class I obese men with chronic-plaque and non-alcoholic fatty liver disease. Sixty men with age ≥ 18 years with class I obesity and with chronic plaque psoriasis and non-alcoholic fatty liver disease were included in the study. All participants were randomly assigned to one of two groups: the first group as the low-calorie-diet group (30 men received immunosuppressive drugs, followed a low-calorie diet, and increased their energy expenditure through a daily 15,000-step outdoor walking program for 12 weeks) and the second as the control group (30 men received immunosuppressive drugs only). The primary outcome consisted of the results of the area and severity index. Weight, BMI, WC, laboratory results such as triglycerides, liver enzymes (alanine transaminase and aspartate transaminase) as well as DLQI were considered as secondary outcomes. While no significant improvements were achieved in the measured variables of the control group, the low-calorie-diet group demonstrated significant improvement in all the measured variables. The results of the present study confirmed that 12-week low-calorie-diet intervention controls BMI, increases the response of psoriasis to pharmacological agents and improves the quality of life. Diet interventions significantly control the elevated hepatic enzymes (aspartate and alanine transaminases) and triglycerides in male patients with chronic-plaque psoriasis and non-alcoholic fatty liver disease.

Recent Advancements in Herbal Bioactive-based Nanoformulations for the Treatment of Psoriasis

Abstract: Psoriasis is a multifaceted inflammatory dermatological skin disease characterized by Tcell (T-lymphocyte) activation, hyperproliferation, and abnormal epidermal keratinocyte differentiation. Natural bioactive agents from plants including Psoralea corylifolia, Nigella sativa, Curcuma longa, Capsicum annum, Smilax china, Woodfordia fructicosa, and others have recently gained a lot of attention for their anti-psoriatic properties. However, inadequate drug absorption, lack of specificity in drug release, and unintended skin reactions largely restrict their clinical efficacy. Nanoformulations improve the pharmacodynamic characteristics that overcome drug delivery challenges and enhance the anti-psoriatic activity. Nanostructured systems such as liposome, ethosome, liposphere, and others have been reported to improve plant extract solubility, penetration, bioavailability, bioactivity, and minimize undesirable effects, providing the way for the development of herbal nanoformulation. This review enlights the therapeutic efficacy of lead phytocompounds and its nanoformulations in managing psoriasis.

The Role of EREG, PTPN1, and SERPINB7 Genes in the Pathogenesis of Psoriasis: May SERPINB7 Be Protective and a Marker of Severity for Psoriasis?

Psoriasis is a chronic inflammatory dermatological disease with complex pathogenesis in which many immune system cells, including keratinocytes, play a role. Many genes regulate the proliferation of keratinocytes and other immune cells that have essential roles in the pathogenesis of psoriasis. The expressions of EREG, PTPN1, and SERPINB7 genes were shown as upregulated in psoriatic skins in a few studies previously. We aimed to evaluate the expressions of these genes in psoriatic lesional skin and compared them with non-lesional adjacent skin of the same patients and normal skin of healthy controls. Our results revealed that the expressions of EREG and PTPN1 genes were upregulated, whereas the SERPINB7 gene expression was down regulated in the psoriatic skin of the patients than normal skin of controls. Moreover, the expression level of the SERPINB7 gene was also negatively correlated with the severity of the disease among patients. According to our results, overexpression of EREG and PTPN1 genes, and decreased expression of SERPINB7 gene may lead to the development of psoriasis.

Interleukin-18 and IL-18BP in inflammatory dermatological diseases.

Interleukin (IL)-18, an interferon-γ inducer, belongs to the IL-1 family of pleiotropic pro-inflammatory factors, and IL-18 binding protein (IL-18BP) is a native antagonist of IL-18 in vivo, regulating its activity. Moreover, IL-18 exerts an influential function in host innate and adaptive immunity, and IL-18BP has elevated levels of interferon-γ in diverse cells, suggesting that IL-18BP is a negative feedback inhibitor of IL-18-mediated immunity. Similar to IL-1β, the IL-18 cytokine is produced as an indolent precursor that requires further processing into an active cytokine by caspase-1 and mediating downstream signaling pathways through MyD88. IL-18 has been implicated to play a role in psoriasis, atopic dermatitis, rosacea, and bullous pemphigoid in human inflammatory skin diseases. Currently, IL-18BP is less explored in treating inflammatory skin diseases, while IL-18BP is being tested in clinical trials for other diseases. Thereby, IL-18BP is a prospective therapeutic target.

Risk of psoriasis in people with hidradenitis suppurativa: A systematic review and meta-analysis.

Hidradenitis suppurativa were associated with comorbidities in various organ systems. Inflammatory dermatological diseases such as pyoderma gangrenosum were reported to be associated with hidradenitis suppurativa. Nevertheless, as for the association between hidradenitis suppurativa and psoriasis, evidences were insufficient. In many studies, the association between psoriasis and hidradenitis suppurativa has been reported. However, some evidence seems to be controversial. The purpose of the systematic review and meta-analysis was to assess whether there was significant association between HS and psoriasis. On June 01, 2022, we appraised 2,795 articles from databases including PubMed, Web of Science and Embase. Search syntaxes were based on 'hidradenitis suppurativa' or 'acne inversa' with "psoriasis", "comorbidities" or 'epidemiology'. Synonyms were determined based on MeSH terms and Emtree. Observational results that evaluated the odds ratio for people with hidradenitis suppurativa who had psoriasis were extracted for qualitative synthesis. After the selection process of the initial 2,795 studies, ten observational studies, including 3 cohort studies, 1 case-control study, and 6 cross-sectional studies, were extracted for critical appraisal. Based on the integration of 7 studies (with more than 560,000 participants included), people with hidradenitis suppurativa had a higher risk of having psoriasis, with a 2.67-fold risk (95% CI, 1.84, 3.87). The association remained in the sensitivity analyses utilizing strict adjustment models. In the analysis that only included studies with a similar study design and adjustments in obesity-related factors, the risk of people with hidradenitis suppurativa having psoriasis was 3.24 (95% CI, 2.27, 4.62). In male patients with HS, the risk of having psoriasis was 4.30-fold higher than male patients without HS (95% CI, 2.37, 7.78). Likewise, in an analysis including 3 cross-sectional studies, the risk of female HS patients having psoriasis was 3.94-fold higher than female HS-free patients (95% CI, 2.34, 6.63). The co-occurrence of hidradenitis suppurativa and psoriasis can greatly increase the burden of the disease. Psoriasis could be one of the critical comorbidities of hidradenitis suppurativa and should be recommended for future screening and follow up. The association between the two diseases should be kept in mind in managing hidradenitis suppurativa patients. More prospective studies are needed to establish the true magnitude of the association between psoriasis and hidradenitis suppurativa.

Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature.

The outbreak of coronavirus disease 2019 (COVID-19) represented a new worldwide challenge, strongly impacting on the global economy, overall health and lifestyle. Since then, several strategies have been adopted to contain the widespread of infection. Among these, vaccination is currently the most important measure to fight against the pandemic. However, several concerns such as slower-than-hoped-for rollout, the hurried approval with limited data, the mechanism of action (in particular mRNA-based), and the uncertain duration of protection they afforded were initially raised. Moreover, even if cutaneous reactions have been rarely reported in clinical trials, global mass vaccination showed several dermatologic reactions not initially recognized, leaving dermatologists to decide how to diagnose and treat them. In this scenario, dermatologists should be ready to promptly recognize these clinical manifestations. Thus, the aim of this manuscript is to review current literature on cutaneous reactions following COVID-19 vaccination, particularly inflammatory dermatological diseases, in order to help clinicians to better understand these dermatological conditions and to provide an extensive overview of all the vaccine-related skin manifestations.

Fabrication of Emulsion Loaded with Cyclosporine and Moringa Oleifera Oil Potentially for Topical Psoriasis Treatment

Psoriasis is a widespread autoimmune inflammatory dermatological disease treated with oral cyclosporine to reduce the uneasiness of psoriasis. However, systemic therapy of cyclosporine is associated with high risk of side effect that limit the usage in psoriasis treatment. Topical delivery of cyclosporine is believed could overcome cyclosporine related toxicity issues. In this study, a new carrier for topical cyclosporine was developed, which cooperated with Moringa oleifera oil (MOO) that has been reported could enhance the moisture-retaining of the skin. Both high-shear homogenizer and overhead stirrer homogenizer were utilized in formulating a cyclosporine-loaded emulsion carrier. Two emulsions were prepared at different proportions of MOO, water and surfactant (Tween80:Span80) based on the constructed ternary phase diagram. Samples with different formulation (E1 and E2) were subjected to several tests including the stability, rheological, colony and in vitro release analysis. E1 and E2 possessed good stability against phase separation for 1 month at different storage temperatures (4, 25 and 40ºC), having pH values within the range of 4 to 5 as well as showing no mould and microbial growth after been incubated on nutrient agar plate at controlled conditions. Optimized formulations were found to be non-Newtonian and followed the pseudoplastic flow behaviour. Nonetheless, E2 exhibited highest permeation of cyclosporine (80.23%) through cellulose acetate membrane via Franz diffusion cell, which correspond to controlled release and best fitted to first order kinetic behaviour (R2=0.9819). This preliminary study suggested that the formulated emulsion has a promising potential as topical medicament for psoriasis.

Use of Contact Immunotherapy in the Treatment of Skin Diseases Other than Alopecia Areata.

For decades, contact immunotherapy with dinitrochlorobenzene, diphencyprone, and squaric acid dibutylester has played an important role in both clinical practice and scientific research. It is listed as the first-line treatment for extensive alopecia areata and was more recently approved for melanoma treatment as an orphan drug in the USA. Moreover, owing to the relative low cost and safety, topical immunotherapy has also been used in many infectious, neoplastic, and inflammatory dermatological diseases. It is especially valuable in vulnerable groups, for cosmetic/pain sensitive areas, or for multiple lesions. In this review, we summarize the current evidence supporting the use of contact immunotherapy for treatment of skin diseases, from articles collected from PubMed database. Owing to space limitation and already numerous studies focusing on alopecia areata, we include only skin diseases other than alopecia areata. In addition to diseases that have been reported to be treated by contact immunotherapy, the hypothesized mechanism, prognosis prediction, efficacy, and safety of these topical agents are discussed.

The Role of Interleukins in the Pathogenesis of Dermatological Immune-Mediated Diseases.

Autoimmune inflammatory diseases are primarily characterized by deregulated expression of cytokines, which drive pathogenesis of these diseases. A number of approved and experimental therapies utilize monoclonal antibodies against cytokine proteins. Cytokines can be classified into different families including the interleukins, which are secreted and act on leukocytes, the tumor necrosis factor (TNF) family, as well as chemokine proteins. In this review article, we focus on the interleukin family of cytokines, of which 39 members have been identified to this date. We outline the role of each of these interleukins in the immune system, and various dermatological inflammatory diseases with a focused discussion on the pathogenesis of psoriasis and atopic dermatitis. In addition, we describe the roles of various interleukins in psychiatric, cardiovascular, and gastrointestinal comorbidities. Finally, we review clinical efficacy and safety data from emerging late-phase anti-interleukin therapies under development for psoriasis and atopic dermatitis. Collectively, additional fundamental and clinical research remains necessary to fully elucidate the roles of various interleukin proteins in the pathogenesis of inflammatory dermatologic diseases, and treatment outcomes in patients.