Cytokines and Other Mediators in Alopecia Areata

Alopecia areata, a disease of the hair follicles with multifactorial etiology and a strong component of autoimmune origin, has been extensively studied as far as the role of several cytokines is concerned. So far, IFN-γ, interleukins, TNF-α, are cytokines that are well known to play a major role in the pathogenesis of the disease, while several studies have shown that many more pathways exist. Among them, MIG, IP-10, BAFF, HLA antigens, MIG, as well as stress hormones are implicated in disease onset and activity. Within the scope of this paper, the authors attempt to shed light upon the complexity of alopecia areata underlying mechanisms and indicate pathways that may suggest future treatments

Skin Biopsy in the Context of Dermatological Diagnosis: A Retrospective Cohort Study

Background. Skin biopsy is an established method for allying the dermatologist in overcoming the diagnostic dilemmas which occur during consultations. However neither do all skin biopsies produce a conclusive diagnosis nor the dermatologists routinely perform this procedure to every patient they consult. The aim of this study was to investigate the favourable clinical diagnoses set by dermatologists when performing skin biopsy, the diagnoses reached by the dermatopathologists after microscopic examination, and the relationship between them and finally to comment on the instances that skin biopsy fails to fulfill the diagnostic task. Methods. Six thousand eight hundred and sixteen biopsy specimens were reviewed and descriptive statistics were performed. Results. The mean age of the patients was 54.58 ± 0.26 years, the most common site of biopsy was the head and neck (38.3%), the most frequently proposed clinical diagnoses included malignancies (19.28%), and the most prevalent pathological diagnosis was epitheliomas (21.9%). After microscopic examination, a specific histological diagnosis was proposed in 83.29% of the cases and a consensus between clinical and histological diagnoses was observed in 68% of them. Conclusions. Although there are cases that skin biopsy exhibits diagnostic inefficiency, it remains a valuable aid for the dermatology clinical practice

Pityriasis rubra pilaris presenting with an abnormal autoimmune profile: two case reports

<p>Abstract</p> <p>Introduction</p> <p>Pityriasis rubra pilaris is an uncommon inflammatory and hyperproliferative dermatosis of juvenile or adult onset. The etiology of the disease is still unknown.</p> <p>Case presentation</p> <p>We present the cases of two Caucasian men aged 53 and 48 who presented with pityriasis rubra pillaris type 1; both patients also exhibited an abnormal immunological profile.</p> <p>Conclusion</p> <p>Pityriasis rubra pillaris is currently classified as a keratinization disorder. The abnormal immunological profile reported in our patients along with the comorbidity of pityriasis rubra pilaris with autoimmune disorders reported in the literature poses the question of a possible pathogenetic role for the immune response in this disorder.</p

Identification of etiologic factors in patients with chronic urticaria

Η διερεύνηση των αιτιολογικών παραγόντων στη χρόνια κνίδωση παραμένει ένα επίκαιρο ερευνητικό-επιδημιολογικό θέμα στην Δερματολογία. Αν και η πρώτη δημοσίευση έγινε πριν από 40 έτη, εξακολουθούν το 2007 να δημοσιεύονται μελέτες σε έγκυρες επιθεωρήσεις για τα αιτιολογικά χαρακτηριστικά των πασχόντων με χρόνια κνίδωση. Η μελέτη αυτή, η μεγαλύτερη σε αριθμό ασθενών που έχει γίνει μέχρι σήμερα, παρουσιάζει αρκετά ενδιαφέροντα νέα στοιχεία από επιδημιολογική οπτική για τους πιθανούς αιτιολογικούς και προγνωστικούς για τη διάρκεια της διαταραχής παράγοντες, καθώς και μια σύγκριση του υποπληθυσμού των χρόνιων κνιδωτικών που παρουσιάζουν και φυσική κνίδωση συγκριτικά με τους υπόλοιπους χρόνιους κνιδωτικούς. Ανακεφαλαιώνοντας, τα δεδομένα που προσθέτει η παρούσα μελέτη στην έρευνα της επιδημιολογίας και αιτιοπαθογένειας της χρόνιας κνίδωσης μπορούν να συνοψιστούν στα εξής: 1. Oι άνδρες σε στατιστικά σημαντικότερο βαθμό εμφανίζουν συχνότερα μόνο χρόνια κνίδωση, ενώ οι γυναίκες συχνότερα χρόνια κνίδωση συνοδευόμενη από αγγειοοίδημα. 2. Επιβαρυντικοί παράγοντες για τη διάρκεια της διαταραχής είναι το γυναικείο φύλο, η ύπαρξη αγγειοιδήματος και η συνύπαρξη μίας ή περισσοτέρων φυσικών κνιδώσεων. 3. Οι φυσικές κνιδώσεις εμφανίζονται συχνότερα σε χρόνιους κνιδωτικούς ασθενείς που έχουν αυξημένο stress καθώς και σε γυναίκες. 4. Η αποκάλυψη της αιτιοπαθογένειας της χρόνιας κνίδωσης στην παρούσα μελέτη των 2523 ασθενών, έγινε σε 38.7% των ασθενών και σ’αυτό βοήθησε κατά κύριο λόγο των ιστορικό και κατά δεύτερο λόγο ο προτεινόμενος με βάση την διεθνή βιβλιογραφία εργαστηριακός έλεγχος. Προτείνουμε επομένως στη διερεύνηση της χρόνιας κνίδωσης ο εργαστηριακός έλεγχος να καθορίζεται βάση ιστορικού, με επικέντρωση στις φυσικές κνιδώσεις, τις υποτροπιάζουσες λοιμώξεις και τις αυτοάνοσες θυρεοειδοπάθειες

Schorzenia paznokci a choroby układowe &#8212; o czym mówi nam wygląd paznokci?

Jak nazywają się dwa przedstawione poniżej schorzenia paznokci? Jakie choroby podstawowe można podejrzewać na podstawie tych zmian? Prawidłowa odpowiedź to onycholiza (po lewej) i czerwony obłączek (po prawej). Jeśli chodzi o choroby podstawowe: pacjent z onycholizą choruje na nadczynność tarczycy, natomiast pacjent z czerwonym obłączkiem na przewlekłą obturacyjną chorobę płuc. Onycholiza i czerwony obłączek są jednymi z częściej spotykanych zmian morfologii (kształtu) i zabarwienia paznokci (dwie kategorie w klasyfikacji zmian paznokci). Zmiany w obrębie paznokci mogą być objawem choroby podstawowej. Z uwagi na łatwość oceny, badanie paznokci może być wygodnym instrumentem diagnostycznym. Przedstawiony w niniejszej pracy przegląd częstych i mniej częstych zaburzeń paznokci pokazuje, jaki rodzaj zmian w obrębie paznokci występuje częściej w przypadku określonych chorób wewnętrznych

Oxybutynin for the Treatment of Primary Hyperhidrosis: Current State of the Art

Oxybutynin is an anticholinergic drug with an emerging role in the treatment of hyperhidrosis. Several recent studies have documented that it is effective both in focal and generalized hyperhidrosis and shows universally good response among different groups of patients regardless of age, gender, and weight. The most common adverse event is dry mouth reported by almost all patients treated. The way this might affect long-term compliance and tolerability should be better investigated in the future

Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn

Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus, eczematous lesions, and relapsing course. It presents with great clinical heterogeneity, while underlying pathogenetic mechanisms involve a complex interplay between a dysfunctional skin barrier, immune dysregulation, microbiome dysbiosis, genetic and environmental factors. All these interactions are shaping the landscape of AD endotypes and phenotypes. In the &ldquo;era of allergy epidemic&rdquo;, the role of food allergy (FA) in the prevention and management of AD is a recently explored &ldquo;era&rdquo;. Increasing evidence supports that AD predisposes to FA and not vice versa, while food allergens are presumed as one of the triggers of AD exacerbations. AD management should focus on skin care combined with topical and/or systemic treatments; however, in the presence of suspected food allergy, a thorough allergy evaluation should be performed. Food-elimination diets in food-allergic cases may have a beneficial effect on AD morbidity; however, prolonged, unnecessary diets are highly discouraged since they can lead to loss of tolerance and potentially increase the risk of IgE-mediated food allergy. Preventive AD strategies with the use of topical emollients and anti-inflammatory agents as well as early introduction of food allergens in high-risk infants seem promising in managing and preventing food allergy in AD patients. The current review aims to overview data on the complex AD/FA relationship and provide the most recent developments on whether food allergy interventions change the AD course and vice versa