Trachyonychia

The word trachyonychia means rough nails. Trachyonychia can present in opaque and shiny variants. This is referred to as opaque trachyonychia and shiny trachyonychia. The diagnosis of trachyonychia is clinical and a nail unit biopsy is not required Trachyonychia is a benign disease that may regress spontaneously. The most common causes of trachyonychia are alopecia areata, lichen planus, and psoriasis. A variety of treatment options exist, and the treatment should be conservative since this is a non-scarring condition

Review Update on Topical Therapy for Psoriasis

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Purpose of Review: Studies show frequent usage but low adherence rates and poor satisfaction from topical therapy for psoriasis. These were attributed to low efficacy, inconvenience of application, and poor cosmetic quality for different body parts. Recent Findings: Multicenter surveys on patients suggest a two-way holistic approach, where patients convey what bothers them most and doctors explain how products address specific concerns. New rapid response targeted topical agents, in cosmetically acceptable preparations, applied less often, are undergoing efficacy and safety studies, ideally on large populations up to 1 year or more. Until available, this review addresses gaps in knowledge on how to maximize effects of emollients, used alone, with physiologic lipids, or as base for active topical therapy. Summary: Updates—on how psoriasis skin becomes itchy, red, dry, thick, and scaly from inflammation and barrier defects—explain clinical responses to the physical, chemical, and functional properties of psoriasis topical therapies

Targeting of anti-citrullinated protein/peptide antibodies in rheumatoid arthritis using peptides mimicking endogenously citrullinated fibrinogen antigens

Introduction: We have previously identified endogenously citrullinated peptides derived from fibrinogen in rheumatoid arthritis (RA) synovial tissues. In this study, we have investigated the auto-antigenicity of four of those citrullinated peptides, and explored their feasibility to target anti-citrullinated protein/peptide antibodies (ACPA). Methods: The autoantigenic potential of the fibrinogen peptides was investigated by screening 927 serum samples from the Epidemiological Investigation of RA (EIRA) cohort on a peptide microarray based on the ImmunoCAP ISAC (R) system. In order to assay for ACPA blocking, two independent pools of purified ACPA were incubated with the respective targeting peptide prior to binding to cyclic citrullinated peptide (CCP) 2 using the CCPlus (R) ELISA kit. Results: Two peptides derived from the fibrinogen a chain, Arg573Cit (563-583) and Arg591Cit (580-600), referred to as Cit573 and Cit591, and two peptides from the fibrinogen beta chain, Arg72Cit (62-81) and Arg74Cit (62-81) (Cit72 and Cit74), displayed 65 %, 15 %, 35 %, and 53 % of immune reactivity among CCP2-positive RA sera, respectively. In CCP2-negative RA sera, a positive reactivity was detected in 5 % (Cit573), 6 % (Cit591), 8 % (Cit72), and 4 % (Cit74). In the competition assay, Cit573 and Cit591 peptides reduced ACPA binding to CCP2 by a maximum of 84 % and 63 % respectively. An additive effect was observed when these peptides were combined. In contrast, Cit74 and Cit72 were less effective. Cyclization of the peptide structure containing Cit573 significantly increased the blocking efficiency. Conclusions: Here we demonstrate extensive autoantibody reactivity against in vivo citrullinated fibrinogen epitopes, and further show the potential use of these peptides for antagonizing ACPA