Xeroderma Research Articles

Cutaneous Manifestations in Patients with Dermatomyositis, Are They Only Skin Deep?

Dermatomyositis (DM) is a rare and severely debilitating autoimmune disease that can affect children and adults; however, there is little understanding of the patient-reported experience and uncertainty around validated clinical outcomes assessments (COAs) that could measure changes in the condition during clinical trials of new treatments. The aim of this study was to understand the patient experience of DM, with a focus on its cutaneous manifestations, to describe the patient experience and determine the suitability of existing COA measures. Adult (≥ 18 years) patients (N = 28) with severe active cutaneous manifestations of DM were interviewed. In the 90-min interviews, open-ended questions and probes were used to elicit descriptions of key clinical manifestations and patients' experiences of DM, including the symptoms and impacts on their daily lives and wellbeing. Patients reported 13 different skin manifestations of DM. The most common were rash (n = 28, 100%), itch (n = 28, 100%), dry skin (n = 23, 82%), and swelling of the skin (n = 17, 61%). The head and face, followed by hands, were perceived as the most bothersome body areas affected by skin manifestations, because they are exposed and visible to themselves and other people. All patients (n = 28, 100%) reported at least one impact of DM, which varied greatly between patients, but included emotional, psychological, cognitive, and physical impacts, and those affecting daily life, such as work and sleep. Over half of the patients (n = 19, 67%) reported that their daily activities were impacted by DM. The qualitative interviews with patients revealed that the presentation of DM manifestations is highly variable but affects patients' emotional wellbeing, physical activities, and daily life significantly.

Efficacy on symptoms and mortality day vs. night administration of EGFR-TKIs for advanced non-small cell lung cancer.

This study has a purpose to investigate the side effects of three EGFR-TKIs targeted therapeutic agents (gefitinib, erlotinib, and afatinib) and all-cause mortality in patients with metastatic lung cancer. We performed a prospective cohort study. We selected all patients with newly diagnosed metastatic lung cancer between January and November 2019. Main exposure was daytime versus nighttime use of targeted EGFR TKIs. The study outcome was a symptom change using the mobile application, and all-cause mortality between January 2019 and March 2023. Among the 87 study participants, 35 (40%) took their medication at night. Among the 87 study participants, 35 (40%) took their medication at night. At 6weeks of treatment, acne (1.36; 95% confidence interval [CI] 1.09, 1.64; p for interaction = 0.04) and dry skin (1.35; 95% CI 1.09, 1.61, p for interaction = 0.01) in the day group showed a much increase from baseline compared to the night group. In contrast, the night group reported greater reductions in lung cancer-related symptoms from baseline compared to the day. During follow-up (median 43months), the night group had a lower risk of all-cause death than the day group, especially in younger patients (adjusted hazard ratio = 0.34; 95% CI 0.13, 0.87). The group taking EGFR-TKIs at night experienced fewer side effects and had longer overall survival compared to the day group. Clinicians should consider recommending that lung cancer patients take their once-daily oral anticancer drugs in the evening rather than the morning to improve treatment outcomes.

The effectiveness of biotin in therapy alopecia of various origins, pathologies of the skin and nails

Biotin deficiency is caused by inflammatory bowel diseases that impair the absorption of the vitamin, special dietary disorders with the consumption of raw eggs (excess avidin – a vitamin B7 blocker protein), magnesium deficiency, smoking, alcohol, treatment with broad-spectrum antibiotics, sulfonamides, and anticonvulsants. Hypovitaminosis B7 has also been noted in individuals with congenital genetic defects of the biotinidase gene or other genes involved in biotin metabolism. Deficiency of water-soluble vitamin B7 (vitamin H) – manifested by dry skin, seborrheic dermatitis, dermatitis around the eyes, nose, mouth, ears and groin, impaired nail growth, slow healing of skin cuts, atopic dermatitis, striations, splitting, brittle nails and alopecia (diffuse and androgenic form). Alopecia occurs when hair follicles die and leads to hair loss. The human proteome contains 51 proteins involved in biotin metabolism. In particular, D-biotin-dependent carboxylases play an important role in the metabolism of fatty acids, amino acids, carbohydrates, cell division and growth, incl. keratinocytes and hair follicle cells. The molecular mechanisms of the effects of D-biotin on the skin and its appendages may involve various growth factors: regulation of the signaling pathways of growth factors (IGF-1, FGF, KGF, HGF, VEGF, SIRT-1, Wnt and beta-catenin) has been shown. Hair follicle stem cells cause the cyclical growth of hair follicles. Growth factors are involved in the activation of stem cell growth by D-biotin; activation of the Wnt/β-catenin signaling cascade leads to the activation of cyclin D1 proteins (initiates DNA synthesis and leads to increased viability of hair follicles. The results of fundamental and clinical studies confirm the prospects of using biotin in dermatology for the treatment of diseases of the skin, hair and nails, incl. alopecia of various origins (androgenic, focal, diffuse). The results of the studies indicated that biotin was well tolerated, and there was no risk of hypervitaminosis even when taking megadoses (hundreds of milligrams).

Efficacy of a Multi-lamellar Emulsion Containing a Synthetic Sphingosine Kinase 1 Activator and Pseudoceramide in Patients with Atopic Dermatitis: A Randomized Controlled Trial.

Patients with atopic dermatitis(AD) have impaired barrier function, which decreases skin hydration, weakens their defense against microorganisms, and culminates in increased inflammatory responses. Here, we conducted a clinical trial to evaluate the efficacy of a multi-lamellar emulsion (MLE) containing the pseudoceramide PC-9S and a synthetic sphingosine kinase 1 (SPHK1) activator, Defensamide™, in improving mild-to-moderate atopic dermatitis. Forty patients aged ≥ 2years were randomized into a combined-therapy group treated with the MLE containing PC-9S and Defensamide™ plus a topical corticosteroid and a topical-corticosteroid-only group. Assessments based on therapeutic methods included the Eczema Area and Severity Index (EASI), the Investigator Global Assessment (IGA), transepidermal water loss (TEWL), stratum corneum hydration (SCH), skin dryness, a visual analogue scale (VAS) of itchiness, a VAS of sleep disturbance, patientsatisfaction, and the Dermatology Life Quality Index (DLQI). Thirty-eight patients completed this study. In the combined-therapy group, significant improvements in clinical and instrumental measures such as EASI scores, skin hydration, and skin dryness were noted at 4weeks compared to baseline, but such improvements were not noted in the topical corticosteroid-only group. Subjective assessments of itching and sleep disturbance and DLQI scores also showed significant improvements in the combined-therapy group. Combined therapy with the MLE containing Defensamide™ and PC-9S and with topical corticosteroid demonstrated superior clinical outcomes compared with topical corticosteroid monotherapy. Our findings underscore the potential of MLE-containing formulations as effective adjunctive therapies for AD, offering both objective and subjective symptomatic relief and enhancing patients' quality of life.

50541 A Single Center, Randomized, Clinical Trial to Assess the Moisturization Efficacy of Topically Applied Mineral Sunscreens Over the Course of 24 Hours After a Single Application Among Adult Subjects with Dry Skin

50541 A Single Center, Randomized, Clinical Trial to Assess the Moisturization Efficacy of Topically Applied Mineral Sunscreens Over the Course of 24 Hours After a Single Application Among Adult Subjects with Dry Skin

51431 Characterizing the stratum corneum lipid profiles in dry and non-dry skin from a polycultural cohort study

51431 Characterizing the stratum corneum lipid profiles in dry and non-dry skin from a polycultural cohort study

Inflammatory biomarkers and clinical adverse effects associated with Isotretinoin treatment: A prospective study

Background Isotretinoin is considered now one of the most important drugs in the treatment of different dermatological diseases. However, different body systems can be affected during the treatment due to isotretinoin induced apoptosis. Objectives To evaluate the clinical adverse effects and laboratory changes associated with isotretinoin used in the treatment of different dermatological diseases. Methods 73 patients on isotretinoin treatment fulfilled a questionnaire about side effects associated with isotretinoin. Complete blood count (CBC), fasting lipid profile, liver enzymes, and the inflammatory markers Monocytes/HDL ratio (MHR), Neutrophil/lymphocyte (NLR), and Platelets/lymphocyte ratios (PLR) were assessed before treatment and monthly during the treatment period. Results The commonest adverse effects were related to dryness of skin and mucus membrane. 32.9% complained of myalgia and 12.3% arthralgia. Headache was reported in 13.7%, mood alteration in 11%, and insomnia in 12.3%. 24.5% of studied females reported menstrual irregularities. There were no statistically significant changes in CBC. TG, cholesterol, AST, ALT, and MHR significantly increased while HDL, NLR and PLR ratios significantly decreased after isotretinoin treatment. Conclusion: isotretinoin affects different body systems by side effects that are reversible in most instances; however, some of them are serious and need regular monitoring especially in high- risk patients.

MANAGEMENT OF HAND ECZEMA (VICHARCHIKA) THROUGH AYURVEDA: A CASE STUDY

Eczema is referred to as "atopic dermatitis." It's a chronic inflammatory skin condition characterised by itchy, red, and dry skin and sometimes scaly patches of skin. These patches may become thickened, cracked, or scaly and can occur anywhere on the body. Eczema often involves periods of flare-ups and remissions and can vary from mild to severe. It is considered a type of allergic or atopic condition, and it's commonly associated with other allergic conditions such as asthma and hay fever. Eczema resembles Vicharchika in Ayurveda. The signs and symptoms of Vicharchika are kandu (itching), pidika (papule), shyava varna (blackish-brown discolouration), and bahusrava (excessive exudation). Case summary: A 29-year-old female patient approached Kayachikitsa Skin OPD with complaints of dry, scaly skin lesions over bilateral palms with redness, cracking, and occasional discharge from lesions associated with severe itching for 10 years; symptoms have aggravated for 15 days. Based on signs and symptoms, an Ayurvedic diagnosis was made as Vicharchika (hand eczema). The subject was given deepana (appetiser)-pachana (carminative), bahya rukshana karma (external dehydrating therapy), then snehapana (internal oleation), followed by Virechana (purgation therapy), and shamana aushadhis (oral medications). The subject showed improvement in signs and symptoms, EASI and DLQI scores.

Hydatid Cyst of The Breast: A Systematic Review

Introduction Due to its rarity, there is limited information regarding breast hydatid disease, mostly derived from case reports. This study aims to review the clinical presentation and management of the disease systematically. Methods The PubMed/Medline and Google Scholar were searched with the following keywords: (Breast OR Breasts OR "mammary gland" AND hydatid OR hydatidosis OR echinococcus OR echinococcal OR echinococcosis OR "E. granulosus"). Only English-language studies published in legitimate journals were included. Additional inclusion criteria involved a confirmed diagnosis of breast hydatid cyst, details on presentation, cyst characteristics, and management. Results Most cases were reported in India (32.6%) and Turkey (25.6%). The mean age of the patients was 40.88 ± 15.7 years, and all 43 patients were female. Most (69.8%) were asymptomatic, while 25.6% reported pain and 2.3% reported dry skin. Surgery with albendazole was the treatment of choice in 51.2% of the cases, followed by surgery alone in 39.5%. Most cases (65.1%) recovered without complications, whereas one did not and was under follow-up. The recovery status was not mentioned in 14 cases (32.6%). Conclusion Breast hydatid cyst is an extremely rare finding that can be asymptomatic in most instances. Surgery combined with albendazole may be the most successful treatment approach.

TRPV4-β-catenin axis is a novel therapeutic target for dry skin-induced chronic itch

Dry skin induced chronic pruritus is an increasingly common and debilitating problem, especially in the elderly. Although keratinocytes play important roles in innate and adaptive immunity and keratinocyte proliferation is a key feature of dry skin induced chronic pruritus, the exact contribution of keratinocytes to the pathogenesis of dry skin induced chronic pruritus is poorly understood. In this study, we generated the acetone-ether-water induced dry skin model in mice and found that epidermal hyperplasia induced by this model is partly dependent on the β-catenin signaling pathway. XAV939, an antagonist of β-catenin signaling pathway, inhibited epidermal hyperplasia in dry skin model mice. Importantly, dry skin induced chronic pruritus also dramatically reduced in XAV939 treated mice. Moreover, acetone-ether-water treatment-induced epidermal hyperplasia and chronic itch were decreased in Trpv4−/− mice. In vitro, XAV939 inhibited hypo-osmotic stress induced proliferation of HaCaT cells, and hypo-osmotic stress induced proliferation of in HaCaT cells and primary cultured keratinocytes were also significantly reduced by blocking TRPV4 function. Finally, thymic stromal lymphopoietin release was examined both in vivo and in vitro, which was significantly inhibited by XAV939 treatment and Trpv4 deficiency, and anti-TSLP antibody treatment significantly decreased AEW-induced scratching behavior. Overall, our study revealed a unique ability of TRPV4 expressing keratinocytes in the skin, which critically mediated dry skin induced epidermal hyperplasia and chronic pruritus, thus provided novel insights into the development of therapies for chronic pruritus in the elderly.

Efektifitas Rebusan Air Daun Sirih Dalam Perawatan Dermatitis Dalam Konsep Asuhan Keperawatan di Kelurahan Pandan Kasturi RT/RW: 01/01 Kecamatan Sirimau Kota Ambon

Occupational skin disease is a skin disorder that occurs due to a person's work and is commonly found in industrial, agricultural, and plantation areas. This disease is caused by materials/substances and processes carried out in the workplace generally and is known as dermatitis. Atopic dermatitis has dry skin and often has itching, allergic rhinitis, nasal obstruction, conjunctiva and pharynx itching, lacrimation, and seasonality when associated with pollen. This study uses a descriptive case study method where the researcher will describe the case experienced by a client with dermatitis. Respondents in this case study were Mr. N who has been experiencing dermatitis for ± 2 weeks in the pandan kasturi village RT / RW: 01/01 which was carried out for 3 days (November 27, 2023-30 November 2023). The results showed that during the 3 days of implementing dermatitis treatment with siri leaf decoction water, there were changes from Mr. N's complaints. Mr. N said the itching on his feet and hands and between his fingers decreased, did not feel itchy at night after treatment with siri leaf decoction water, redness and wounds due to frequent scratching seemed to decrease. It can be concluded that betel leaf cooking water is effective for the treatment of itching in dermatitis.

Effects of a pH-Regulating Emollient Cream in Mild Atopic Dermatitis Patients with Moderate Localized Lesions

Introduction: Increased skin pH values in patients with atopic dermatitis (AD) contribute to poor antimicrobial and permeability barrier functions of the skin. In practice, the majority of topical preparations available for dry skin conditions do not provide sufficient pH and buffering capacity for maintaining optimum skin surface conditions. To address this issue, we tested a novel zinc lactobionate preparation to determine whether the regular application would lower skin surface pH, and in doing so improve the condition of lesional skin. Methods: The assessment for local severity of AD was done with the Scoring Atopic Dermatitis Index (SCORAD) and skin dryness was assessed by capacitance measurement. Results: The results showed that the test product lowered skin pH and improved AD skin lesions from moderate to mild during 2 weeks of application. In the treated area a lowered pH of about 0.85 units was found. Together with the lowering of pH, the local SCORAD significantly improved from 8.3 on average down to 4.0, while in the untreated area, only a slight improvement (from 8.2 to 6.4) was found. Conclusion: Synergistic effects of the test product’s pH lowering and emollient properties might explain the observed improvements in clinical signs of AD and further research against a comparator would allow the specific contribution of pH modulation to these improvements to be unambiguously isolated.

An adolescent case of doxylamine-induced widening of QRS complex

Doxylamine is an over-the-counter first-generation antihistamine used in the treatment of allergies and insomnia. Intentional ingestion is common due to its wide availability. Toxicity most frequently presents as an anticholinergic toxidrome with central effects leading to delirium, psychosis, or seizures, and peripheral effects manifested as tachycardia, dry and warm skin, mydriasis, or urinary retention. First-generation antihistamines can have antagonistic properties against the sodium channels on the cardiac myocytes in supratherapeutic doses. This article reports a polysubstance ingestion of 2 antihistaminergic agents with development of QRS complex widening and a right bundle branch block, which has not been well described in the literature.

Impact of physical activity and diet in the treatment of hypothyroidism: A systematic review

Introduction and Objective: Thyroid diseases constitute a significant health challenge of the 21st century. Due to the growing awareness of the accompanying symptoms and the impact of the proper functioning of the thyroid gland on the overall condition of the body, patients show increasing interest in therapeutic methods. The main aim of the article is to present the impact of physical activity and proper diet on the management of patients with hypothyroidism. Review and Methods: Review and summary of studies and meta-analysis of studies available in open-source format on Google Scholar, Web of Science and PubMed. Abbreviated Description of the State of Knowledge: Hypothyroidism is a clinical condition characterized by the insufficient production of thyroid hormones by the thyroid gland. This hormonal deficiency leads to a generalized decrease in metabolic processes. Clinically, hypothyroidism is diagnosed based on elevated serum levels of thyroid-stimulating hormone (TSH) and decreased levels of free thyroxine (T4). Prevalent symptoms include fatigue, constipation, weight gain, cold intolerance, depression and dry skin. Effective management typically involves hormone replacement therapy with synthetic thyroxine. Summary: Hypothyroidism is a complex disease influenced by many factors. A multidisciplinary approach is recommended in its treatment, including pharmacological treatment, diet and appropriately selected physical activity. Early diagnosis and treatment are essential to improve the physical and mental condition of patients.

Explicating the multifunctional roles of tocotrienol and squalene in promoting skin health.

The skin is the largest organ in the integumentary system, protecting against various external threats, including ultraviolet exposure, heat, infections, dehydration and mechanical injuries. Skin disorders can arise from various causes, including allergic reactions or breaches in the skin barrier, which allow microorganisms or chemicals to penetrate the sweat ducts. These conditions encompass a wide range of issues, including acne, xerosis (dry skin), fungal infections, atopic dermatitis (eczema) and psoriasis. Collectively, these ailments affect a significant portion of the global population, impacting approximately one-third of people worldwide. Additionally, oxidative stress induced by ageing and prolonged exposure to ultraviolet rays can manifest in visible alterations such as pigmentation, wrinkling and dehydration. Recent investigations have underscored the potential of natural antioxidant compounds in safeguarding skin health and combating ageing-related changes. Tocotrienols, a subgroup of vitamin E, have garnered significant attention owing to their antioxidant and anti-inflammatory properties. Significant amounts of tocotrienols can be found in rice bran, olive, oats and hazelnuts. Similarly, squalene, predominantly sourced from fish liver oils such as those from sharks, has been used as an emollient in cosmetic formulations. This article offers a comprehensive review of existing literature elucidating the dermatological benefits associated with tocotrienols and squalene, emphasising their roles as antioxidants, anti-inflammatories, skin barrier protection and facilitators of wound healing. Moreover, it sheds light on contemporary research findings suggesting these compounds' therapeutic promise in managing and ameliorating various skin conditions.

Evaluating the tolerability and acceptability of a locally produced alcohol-based handrub and hand hygiene behaviour among health workers in Sierra Leone: a longitudinal hospital-based intervention study

BackgroundAlcohol-based handrub (ABHR) is the gold standard for hand hygiene (HH) and is a cornerstone of infection prevention and control (IPC) strategies. However, several factors influence the efficient use of ABHR by health workers. This study evaluated the tolerability and acceptability of a locally produced ABHR product and HH behaviour among health workers.MethodsA longitudinal hospital-based intervention study was conducted in accordance with the WHO’s standardized protocol for evaluating ABHR tolerability and acceptability (Method 1). Sixty health workers across 4 hospitals in Sierra Leone were observed over a 30-day period at three separate visits (days 1, 3–5, and 30) by trained observers. The outcomes of interest included skin tolerability and product acceptabilityevaluated using subjective and objective measures.ResultsObjective and subjective evaluations demonstrated strong skin tolerability and high acceptability with the product. At all three visits, the skin tolerability score assessed by trained observers was < 2 in ≥ 97% of participants, exceeding the WHO benchmark score (BMS = < 2 in ≥ 75%). Participants’ self-evaluations of overall skin integrity were 97% (visit 2) and 98% (visit 3) for scores > 4 (BMS = > 4 in ≥ 75%). The primary acceptability criteria increased up to 95% (colour) and 88% (smell) at visit 3 (BMS = > 4 in ≥ 50%). Despite high acceptability, the product’s drying effect remained low at 52% and 58% during visits 2 and 3, respectively (BMS = > 4 in ≥ 75%). There were positive HH behaviours (n = 53, 88%), with more than half (n = 38, 63%) of them exhibiting HH at almost every HH moment. The mean ABHR was notably high (76.1 ml, SD ± 35), especially among nurses (mean = 80.1 ml) and doctors (mean = 74.0 ml).ConclusionThe WHO-formulated, locally produced ABHR was well tolerated and accepted by health workers. These findings support the continuous utilization of evidence-based, cost-effective hand hygiene interventions in resource-limited settings. High handrub consumption and frequent HH practices were noticeable HH behaviours. Further research is recommended to optimize product formulations for skin dryness and investigate the association between ABHR consumption and hand hygiene compliance.

Causal effects of skin microbiota on intervertebral disk degeneration, low back pain and sciatica: a two-sample Mendelian randomization study

ObjectiveThe purpose of this study is to use two-sample Mendelian randomization (MR) to investigate the causal relationship between skin microbiota, especially Propionibacterium acnes, and intervertebral disc degeneration (IVDD), low back pain (LBP) and sciatica.MethodsWe conducted a two-sample MR using the aggregated data from the whole genome-wide association studies (GWAS). 150 skin microbiota were derived from the GWAS catalog and IVDD, LBP and sciatica were obtained from the IEU Open GWAS project. Inverse-variance weighted (IVW) was the primary research method, with MR-Egger and Weighted median as supplementary methods. Perform sensitivity analysis and reverse MR analysis on all MR results and use multivariate MR to adjust for confounding factors.ResultsMR revealed five skin microbiota associated with IVDD, four associated with LBP, and two with sciatica. Specifically, P.acnes in sebaceous skin environments were associated with reduced risk of IVDD; IVDD was found to increase the abundance of P.acnes in moist skin. Furthermore, ASV010 [Staphylococcus (unc.)] from dry skin was a risk factor for LBP and sciatica; ASV045 [Acinetobacter (unc.)] from dry skin and Genus Rothia from dry skin exhibited potential protective effects against LBP; ASV065 [Finegoldia (unc.)] from dry skin was a protective factor for IVDD and LBP. ASV054 [Enhydrobacter (unc.)] from moist skin, Genus Bacteroides from dry skin and Genus Kocuria from dry skin were identified as being associated with an increased risk of IVDD. Genus Streptococcus from moist skin was considered to be associated with an increased risk of sciatica.ConclusionsThis study identified a potential causal relationship between skin microbiota and IVDD, LBP, and sciatica. No evidence suggests skin-derived P.acnes is a risk factor for IVDD, LBP and sciatica. At the same time, IVDD can potentially cause an increase in P.acnes abundance, which supports the contamination theory.

Antipruritic effect of ursolic acid through MRGPRX2/MrgprB2-dependent inhibition of mast cell degranulation and reduced TSLP production

Ursolic acid (UA), a pentacyclic triterpene, exhibits diverse pharmacological effects, including potential treatment for allergic diseases. It downregulates thymic stromal lymphopoietin (TSLP) and disrupts mast cell signaling pathways. However, the exact molecular mechanism by which UA interferes with mast cell action remains unclear. Therefore, the current study aimed to uncover molecular entities underlying the effect of UA on mast cells and its potential antipruritic effect, specifically investigating its modulation of key molecules such as TRPV4, PAR2, and MRGPRX2, which are involved in TSLP regulation and sensation.Calcium imaging experiments revealed that UA pretreatment significantly suppressed MRGPRX2 activation (and its mouse orthologue MrgprB2), a G protein-coupled receptor predominantly expressed in mast cells. Molecular docking predictions suggested potential interactions between UA and MRGPRX2/MrgprB2. UA pretreatment also reduced mast cell degranulation through MRGPRX2 and MrgprB2-dependent mechanisms. In a dry skin mouse model, UA administration decreased tryptase and TSLP production in the skin, and diminished TSLP response in the sensory neurons. While PAR2 and TRPV4 activation enhances TSLP production, UA did not inhibit their activity. Notably, UA attenuated compound 48/80-induced scratching behaviors in mice and suppressed spontaneous scratching in a dry skin model.The present study confirms the effective inhibition of UA on MRGPRX2/MrgprB2, leading to reduced mast cell degranulation and suppressed scratching behaviors. These findings highlight the potential of UA as an antipruritic agent for managing various allergy- or itch-related conditions.

Allergy in HIV-Infected patients (on the example of clinical observation)

The article is devoted to the study of the causes of the formation of allergic diseases in patients with HIV infection on the example of a clinical case. Patient C., 35 years old, was under medical supervision at the Victory Clinic from 2013 to 2015 with manifestations of skin allergies. Over the next four years, the patient received therapy for exacerbation of atopic dermatitis, followed a diet with the exception of dairy products and beef. The patient’s condition could be assessed as satisfactory; relapses of atopic dermatitis were noted 2 times after a violation of the diet. In 2017, after an unprotected contact, the patient noticed: weakness, weight loss, dry skin and enlarged peripheral lymph nodes. In June 2017, the patient turned to the district pediatrician, who prescribed a referral for a general blood and urine test, a blood test for AIDS and hepatitis. As a result of the examination, the patient was diagnosed with HIV infection. The patient was examined and treated at the Yakutsk AIDS center. Since August 2017, the patient has been worried about nasal congestion, sneezing, watery eyes, and headaches. In early September 2017, the patient turned to an allergist-immunologist. An examination was conducted: a blood test was taken for allergoscreen panel No. 1 and an immunogram, rhinocytogram. The following results were obtained: according to allergoscreen No. 1, allergy to birch 3.0, milk 3.2, wheat flour 2.8. Rhinocytogram data from 09/28/2017: neutrophils 67 per-field and eosinophils 10 per-field. People infected with the human immunodeficiency virus (HIV) have high levels of allergic conditions, including allergic rhinitis (hay fever), drug allergies and asthma. The HIV virus infects and destroys CD4+T cells, a type of white blood cell. This leads to a change in immune function, which contributes to the development of allergies, infections, cancer and other immune problems. In a patient with HIV infection, after the pathology is detected, the formation and transformation of allergic diseases is observed. The formation of allergopathology in HIV patients is associated with a reduced level of CD4+ cells, which is one of the factors contributing to the development of allergy transformation. The treatment of allergic diseases such as: bronchial asthma, atopic dermatitis, allergic rhinitis and allergic urticaria in patients with HIV is the same as in patients not infected with HIV. Oral administration of glucocorticosteroids should be avoided due to the immunosuppressive effects of this group of drugs.

Overexpression of the β-Subunit of Acid Ceramidase in the Epidermis of Mice Provokes Atopic Dermatitis-like Skin Symptoms.

We previously reported that a pathogenic abnormality in the barrier and water-holding functions of the stratum corneum (SC) in the skin of patients with atopic dermatitis (AD) is mainly attributable to significantly decreased levels of total ceramides in the SC. That decrease is mediated by the abnormal expression of a novel ceramide-reducing enzyme, sphingomyelin/glucosylceramide deacylase (SGDase), which is the β-subunit (ASAH1b) of acid ceramidase. In this study, we determined whether mice overexpressing ASAH1b in their epidermis develop AD-like skin symptoms. We generated transgenic (TG) mice overexpressing ASAH1b, regulated by the involucrin promoter, to localize its expression in the upper epidermis. After hair removal using a depilatory cream containing glycolic acid, the TG mice without any visible skin inflammation at 8 weeks of age had increased levels of ASAH1b and decreased levels of SC ceramide, with disrupted barrier functions measured by trans-epidermal water loss compared to the wild-type (WT) mice. Interestingly, enzymatic assays revealed that SGDase activity was not detectable in the skin of the TG mice compared to WT mice. Immunological staining revealed that there was an increased expression level of IL-33 in the epidermis and an accumulation of macrophages in the dermis of TG mice compared to WT mice, which are phenotypic characteristics of AD, that were exacerbated by tape-stripping of the skin. In the skin of the TG mice, the mRNA levels of IL-5, CCL11, IL-22, CXCL10, and IFNγ were significantly upregulated compared to the WT mice, and tape-stripping significantly increased the mRNA levels of IL-4, IL-33, CXCL1, CXCL12, TLR9, and CD163 compared to WT mice. These findings strongly indicate that the skin of the depilatory cream-treated TG mice exists in an atopic dry skin condition that is highly sensitive to various environmental stimuli. The sum of our results suggests that ASAH1b itself, even in the absence of its enzymatic activity, is a major etiologic factor for atopic dry skin symptoms via an unknown mechanism.