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Cellulitis is a cutaneous infection of the dermis and subcutaneous tissue. There are no existing gold standard diagnostic techniques for differentiating between cellulitis and clinical mimickers ("pseudocellulitis"). New optical technologies in development could aid diagnosis, specifically: an oxygen-sensing bandage developed by this group. There is evidence that inflammation, metabolic derangement and vascular changes alter tissue oxygenation (pO2). Detection of these changes may help differentiate infectious vs.
Mucous membrane pemphigoid (MMP) is an autoimmune blistering disease involving mucosae with heterogeneous disease presentation and autoantigen reactivity. The goal of this study was to determine if MMP could be resolved into endotypes, based on clinical features or antigenic target. 71 patients (37 female/ 34 male) who met clinical and histologic criteria for MMP were identified in our REDCap database; clinical information and sites of involvement were confirmed by exam and chart review. Serum autoantibody targets were evaluated via indirect immunofluorescence, ELISA (BP180, BP230, Col VII), and blotting (BP180, α6β4 integrin and Laminin 332).
Plastic products produced with phthalates as plasticizers have created health concerns since phthalates are believed to cause hormonal and immune dysregulation. Thus, we sought to explore the association between phthalate exposure and psoriasis. Using the 2005-2006 National Health and Nutrition Examination Survey, we conducted a cross-sectional analysis to investigate the association between urinary phthalate metabolite levels and psoriasis severity. We calculated odds ratios (OR) using logistic regression and performed a linear regression to assess for a relationship between urine phthalate levels and psoriasis severity.
Almost 90% of the world’s population has mobile coverage; recent advances in mobile technology hold promise to improve access to dermatology care worldwide. However, research on the use of mobile technology for teledermatology in underserved regions remains limited. We conducted a pilot study to compare diagnostic concordance of assessment of images vs. in-person assessment, histopathological and/or laboratory results in an outpatient dermatology clinic at an academic institution in India. Of the 152 patient cases, 127 cases had both in-person assessment and diagnosis rendered by photo 1-2 months later, by the same dermatologist, with an intra-observer concordance of 91.3%.
Oxidative stress plays a pivotal role in skin aging and carcinogenesis. NAD(P)H dehydrogenase [quinone] 1 (NQO1; EC:18.104.22.168) is a prototypical phase 2 enzyme involved in cytoprotection from oxidative stress and mutagenicity. Phytochemicals such as sulforaphane (SF) or curcumin (CUR) can be highly protective by inducing these enzymes in mammals. Topical SF or its precursor glucoraphanin (GR) from broccoli sprouts induce NQO1 activity in mice. Ex vivo treatment of full thickness human skin with SF induces NQO1 gene expression.
Primary melanomas >1 mm thickness can be cured by resection, but may recur metastatically. We assessed the prognostic value of “T cell fraction” (TCFr) and “repertoire T cell clonality”, as measured by high-throughput sequencing of the T cell receptor beta-chain (TCRB), in primary melanomas (n=377) from patients followed five years. We included T2-T4 melanomas. All samples were scored for TIL content by histopathology. To assess T cell subsets, we further stained sections by multiplex immunohistochemistry (mIHC) for CD3, CD8, CD4, FoxP3, CD39 and CD103.
Despite nearly 40 years of clinical use and research, the mechanism of action of isotretinoin in the treatment of severe acne is still relatively unknown. Utilizing next-generation sequencing and computational modeling, we investigated the genomic changes induced by isotretinoin treatment in both cell lines and in patient skin samples. Sebocytes (SEB-1), keratinocytes (NHEK), and fibroblasts (NHDF) were treated with either vehicle or 0.1μM isotretinoin for 72hrs. Skin punch biopsies were collected from non-lesional back skin of acne patients prior to isotretinoin treatment, after 1, 8, or 20 weeks of treatment, and 6 months after cessation of therapy (n > 6/time point).
Pityriasis Rubra Pilaris (PRP) is a rare and debilitating cutaneous disease characterized by widespread red scaly plaques, follicular papules, and palmoplantar keratoderma. The pathogenesis of PRP is poorly understood, although overexpression of Th17 cytokines have been reported suggesting an inflammatory pathogenesis that may share features with psoriasis. In this study, we used OLINK proximity extension assay technology to quantitate 92 plasma inflammatory proteins of 11 PRP patients treated with ixekizumab (NCT03485976).
Facial skin cancers impair psychosocial health. Peer mentorship programs provide emotional and social support for many oncologic patients but have not been studied in skin cancer. This pilot study evaluated feasibility and satisfaction with a peer mentorship program for facial skin cancer patients treated with Mohs micrographic surgery (MMS). An IRB-approved, randomized controlled trial was performed in an academic center from 2018 to 2019. Patients one year removed from MMS treatment of a facial skin cancer were enrolled and trained as mentors.
Cutaneous T cell lymphoma (CTCL) represents a distinct subgroup of non-Hodgkin lymphomas of mature skin tropic malignant T cells. Although the immune dysregulation is critical for the pathogenesis of lymphoma, the precise mechanism of CTCL pathogenesis remains unknown. Recently, few studies reported the defective T cell function during the onset and progression of certain types of lymphoma. However, the presence of interleukin-9 (IL-9) producing Th9 cells and more importantly, the roles of IL-9/Th9 axis in tumor cell metabolism and survival remain unexplored.
Eccrine sweat is a rich, accessible biofluid comprised of a mixture of electrolytes, metabolites, hormones, and cytokines. Collection of sweat typically relies on absorbent pads that are incompatible with remote monitoring and deployment in field settings due to contaminants in the pads, long-term exposure of sweat to skin, and the need for centrifuges for extraction. Recent advances in the development of wearable microfluidic sensors that capture and analyze sweat dynamics offer new possibilities for tracking sweat biomarkers.
For more than a decade, we have demonstrated the importance of circadian rhythm for skin homeostasis and repair. To advance this research, our objective was to identify metabolite profile changes in skin over a 12-hour period, and to understand how age and treatment influence these changes in both Caucasian and Chinese women. An emerging technique for skin diagnostics is metabolomics, or the study of metabolites, which are small molecule substrates, intermediates, and end-products of biological processes.
Psoriasis is a chronic, immune mediated inflammatory skin disease marked by hyperproliferation, abnormal keratinocyte (KC) differentiation, and leukocyte infiltration. Interleukin (IL)-17 – CCL20 axis has been identified as a critical pathway In the Pathogenesis of psoriasis. Overexpression of IL-17A has been implicated with epidermal hyperproliferation and a robust inflammatory response. Since T cells, particularly Th17 cells (IL-17 producing cells), are implicated in inflammatory skin diseases and because targeting IL-17 has been a promising approach in clearing moderate to severe plaque psoriasis, we investigated the role of T cell cytokines such as IL-17 alone or in combination with interferon (IFN)-γ (Th1 cytokines) in exacerbating inflammatory responses using a reconstructed 3D human psoriatic tissue model.
Dermatomyositis (DM) is an autoimmune disease that affects skin and muscle. Type I IFNs, such as IFNb, are implicated in the pathogenesis of DM, but little is known about IFNg. Our prior studies showed a reduction of IFNg after treatment with Lenabasum, a nonpsychoactive CB2 receptor (CB2R) agonist. We aim to identify major producers of IFNg and understand the distribution of CB2R in the blood vs skin of DM patients. Flow cytometry was performed on PBMCs from 3 healthy controls (HC) and 7 DM patients.
Netherton Syndrome (NS) is a rare autosomal recessive skin disease due to loss-of-function mutations in SPINK5 encoding LEKTI. NS combines a severe skin barrier defect with superficial scaling, skin inflammation, and multiple allergies associated with high serum IgE levels. Increased IL-17 pathway has been reported in NS patients’ skin and peripheral blood, identifying IL-17 as a potential therapeutic target. We report compassionate treatment of 3 adult NS patients with the humanized anti-IL-17 monoclonal antibody ixekizumab (IXE).
Potential of artificial intelligence (AI) for image analysis is proved year by year in many fields including medical situation. Since most of skin diseases reveal their symptoms on skin surface, AI application to dermatology clinic is highly expected. However, even though lesions are on skin, anonymous image collection of skin diseases cannot develop accurate dermatology AI or lead misdiagnostic AI to make confusion in dermatology in worst scenarios, because dermatological diagnosis is a sort of state-of-the-art inspection technique.
Pruritus is a hallmark of atopic dermatitis (AD). Measuring scratching activity, a natural response to itch, is one potential surrogate marker for assessing pruritus. However, current methods such as actigraphy to objectively quantify pruritus, particularly in children, are limited due to confounding from non-scratching hand motions and omitting fine finger scratching. In order to more accurately measure scratching, we present the use of a small, skin-mounted soft flexible sensor (4.5 cm x 2.1 cm, 7 g) with an embedded high frequency 3-axis (0-2000 Hz) accelerometer in direct mechanical communication with the dorsum of the hand to simultaneously capture motion and acoustic signatures of scratching.
Antisynthetase syndrome (AS) and Dermatomyositis (DM) are rare inflammatory autoimmune diseases that some consider as separate entities. AS is poorly defined and some patients have skin lesions consistent with DM. To investigate differences between AS and DM relative to control (HC), we identified immunophenotypes. 3 AS, 3 DM, and 3 HC formalin-fixed, paraffin-embedded (FFPE) samples obtained from back, arm, or leg were stained via immunofluorescence for MxA and IFNβ. Three 20x regions were acquired on Nikon Eclipse.
Hidradenitis Suppurativa is an autoinflammatory disorder of keratinization with a major inflammatory contribution from the Th17 axis. We have previously shown that in addition to previously described IL-17A & IL-17F; IL-17C is found at higher levels by both IHC and rt-PCR in lesional HS skin. We asked whether the IL-17 axis mediates disease activity by using an IL-17RA antagonist Brodalumab to examine histological and transcriptomic features of disease in 10 individuals with HS. Biopsies as per previously published consensus criteria were taken at Baseline and at Weeks 4 and 12 after treatment with an IL-17RA antagonist.
Postherpetic neuralgia (PHN) is a dermatologic disorder with no established cure. The distinct dermatomal distribution of PHN makes the peripheral nerve supplying the dermatome and its distal cutaneous branches the ideal therapeutic target; however, the short acting nature of current medications limits the use of this localized approach. Herein we demonstrate the effects of a drug-free, injectable coolant with long-lasting pain suppression capabilities that could potentially be used for treatment of PHN.