Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV).

BACKGROUND Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or, most frequently, generalized bullous lesions. A subset of patients only develops excoriations, prurigo-like lesions, and eczematous and/or urticarial erythematous lesions. The disease, which is significantly associated with neurological disorders, has high morbidity and severely impacts the quality of life. OBJECTIVES AND METHODOLOGY The Autoimmune blistering diseases Task Force of the European Academy of Dermatology and Venereology sought to update the guidelines for the management of BP based on new clinical information, and new evidence on diagnostic tools and interventions. The recommendations are either evidence-based or rely on expert opinion. The degree of consent among all task force members was included. RESULTS Treatment depends on the severity of BP and patients' comorbidities. High-potency topical corticosteroids are recommended as the mainstay of treatment whenever possible. Oral prednisone at a dose of 0.5 mg/kg/day is a recommended alternative. In case of contraindications or resistance to corticosteroids, immunosuppressive therapies, such as methotrexate, azathioprine, mycophenolate mofetil or mycophenolate acid, may be recommended. The use of doxycycline and dapsone is controversial. They may be recommended, in particular, in patients with contraindications to oral corticosteroids. B-cell-depleting therapy and intravenous immunoglobulins may be considered in treatment-resistant cases. Omalizumab and dupilumab have recently shown promising results. The final version of the guideline was consented to by several patient organizations. CONCLUSIONS The guidelines for the management of BP were updated. They summarize evidence- and expert-based recommendations useful in clinical practice

Chemical constituents and antimicrobial activity of the essential oil from vicia dadianorum extracted by hydro and microwave distillations

The aim of this research was to investigate the influence of extraction methods on yield and chemical composition of the essential oil of Vicia dadianorum Somm. & Lev. The volatiles of V. dadianorum have been isolated by hydro and microwave distillations (HD and MD). The compositions of the essential oils were characterized by GC-FID and GC-MS. A total of seventy-six and fifty-six compounds were identified, constituting over 90.9%, and 80.1% of oil composition of V. dadianorum, respectively. Sesquiterpene hydrocarbons were shown to be the main group of volatiles (HD: 26.2% and MD: 15.9%). The major terpene constituent of the essential oils of V. dadianorum was ?-elemene (HD, 13.7% and MD, 8.4%). Comparative study showed that the amount of total volatiles (90.9%) and the major constituent (26.2%) were found to be better in HD of V. dadianorum. The antimicrobial activity of the isolated essential oils of the plant was also investigated, and it showed moderate antimicrobial and antifungal activities against Staphylococcus aureus, Enterococcus faecalis, Bacillus cereus, Mycobacterium smegmatis and Candida albicans

Antimicrobial activity and chemical composition of the essential oil from Campanula glomerata L. subsp. hispida (Witasek) Hayek

The volatile components of the essential oil from Campanula glomerata L. subsp. hispida (Witasek) Hayek was analyzed by GC and GCMS. Forty-eight compounds representing 89.0 % of the total oil were characterized and the main constituents of this specie were found to be hexadecanoic acid (24.51 %), docosane (15.9 %), isocitronellene (12.6 %), heneicosane (4.6 %), hexahydrofarnesyl acetone (3.2 %), ?-tricosene (1.6 %), octadecanol (1.4 %), caryophyllene oxide (1.3 %), ?-funebrene (1.2 %), ?-thujaplicinol (1.1 %), pentadecanoic acid (1.1 %), tricosane (1.1 %), (2E,4E)-decadienal (1.0 %), (E)-?-damascenone (1.0 %) and (E)-caryophyllene (1.0 %). The antimicrobial activity of the isolated essential oil of the plant was also investigated and it showed moderate antimicrobial and antifungal activities against Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis, Bacillus cereus, Mycobacterium smegmatis, Candida albicans and Saccharomyces cerevisiae

Composition and antimicrobial activity of essential oil from the flower of Rhododendron luteum Sweet

Essential oil from air-dried flower of Rhododendron luteum Sweet (Ericaceae), was obtained by hydrodistillation in a Clevenger-type apparatus and analyzed by GC-MS and GC-FID. Sixty-four components were identified in the oil. The most abundant components in the investigated essential oil from the flower of R. luteum was found to be a-cadinol (8.9 %), d-cadinene (7.6 %), ?-terpineol (7.2 %), benzyl salicylate (6.2 %), ?-muurolene (4.1 %) and 1,6-germacradien-5?-ol (3.4 %). The antimicrobial activity of the isolated essential oil was investigated and it showed moderate antimicrobial activity against Serratia marcescens, Enterococcus faecalis and Staphylococcus aureus, but no antifungal activity was observed against yeast like fungi

Altitude variation in the composition of essential oils, fatty acid methyl esters, and antimicrobial activities of two subspecies of primula vulgaris grown in Turkey

In this study, the changes caused by variation of altitude to the essential oils (EOs), fatty acid methyl esters (FAMEs), and antimicrobial activities of Primula vulgaris Huds. subsp. vulgaris (Pvv) and P. vulgaris Huds. subsp. sibthorpii (Hoffmanns) W.W.Sm. and Forrest (Pvs)) grown in Turkey were investigated. Major fluctuations in the composition of Pvv and Pvs oils included methyl-4-methoxy salicylate (4.5-35.3%; Pvv and 3.2-37.2%; Pvs), (Z,Z,Z)-7,10,13- hexadecatrienal (5.1-21.8%; Pvv and 4.4-15.2%; Pvs ) and flavone (5.5-14.9%; Pvv and 1.6-18.0%; Pvs). Fatty acid profile (C6:0-C26:0) changes were noted in Pvv and Pvs. Methyl hexadecanoate (2.4-9.3%) and methyl octadecanoate (1.0-4.7%) were present in all the FAME samples of the plants. The antimicrobial activity of the EOs of Pvv and Pvs were tested against nine bacterial species, which showed activity against Mycobacterium smegmatis with minimum inhibitory concentrations (MIC) varying from 8.5 to 59.2 ?g/mL in all samples, respectively, depending on the altitude at which the oils were obtained

Essential oil analysis and antimicrobial activity of neckera complanata (Hedw.) huebener and neckera crispa Hedw. (Neckeraceae) grown in Turkey

In this work, the essential oils obtained by hydrodistillation from Neckera complanata (Hedw.) Huebener and Neckera crispa Hedw (Neckeraceae) were analyzed by GC-FID and GC-MS. Twenty-one compounds in the oil of N. complanata, representing 71.61 % and forty-two compounds in the oil of N. crispa, representing 82.12 %, were identified. The essential oil of N. crispa was rich in terpenes (58.68 %) with ?-phellandrene (20.00 %), camphene (10.36 %), ?-bisabolene-E (5.51 %) and ?-pinene (3.49 %) as the major components, respectively. 3-Octanone (22.26 %) and limonene (2.97 %) were the major constituents of the essential oil of N. complanata. The antimicrobial activities of the isolated essential oils of the mosses were also investigated. The essential oil of N. complanata showed only moderate antibacterial activities against Staphylococcus aureus, Enterococcus faecalis and Bacillus cereus with 576 ?g/mL (each). But all the oils showed good antimycotic activity against Candida albicans with in the range of 573-576 ?g/mL, respectively. The aim of this work was to characterize the variation in the essential oil composition of N. complanata and N. crispa grown in Turkey and to identify environmental factors associated with differences in essential oil composition as well as to evaluate their antimicrobial activity

Chemical composition and antimicrobial activity of the volatile of Gladiolus atroviolaceus boiss

In the present study, essential oil extracted by hydrodistillation from Gladiolus atroviolaceus Boiss. (Iridaceae) was analyzed by gas chromatography (GC) and GC-mass spectrometry (MS). A total of 52 compounds were identified, constituting over 93.8 % of the oil composition of G. atroviolaceus. Hexadecanoic acid (44.4 %) and heneicosane (6.6 %) were the major compounds in the volatile of G. atroviolaceus. Sesquiterpene hydrocarbons were shown to be the main groups of terpenoids in the oils (2.6 %). The major terpene constituents of the essential oil of G. atroviolaceus were limonene, g-muurolene and linalool. The antimicrobial activity of the isolated essential oil of the plant was also investigated and it showed moderate antimicrobial and antifungal activities against Staphylococcus aureus, Bacillus cereus, Mycobacterium smegmatis and Candida albicans

Volatile constituents and antimicrobial activity of the essential oils from Cladonia rangiformis Hoffm. and Cladonia furcata (Huds.) Schrad

This study was designed to examine the chemical compositions and antimicrobial activities of the essential oils from Cladonia rangiformis Hoffm. and Cladonia furcata (Huds.) Schrad. The essential oils were isolated by hydrodistillation and analyzed with GC and GC-MS and screened for their in vitro antimicrobial activity in a microdilution assay. In total, 25 and 12 compounds were identified from the oil of C. rangiformis and C. furcata, accounting for 89.2 % and 91.6 % of the detected GC peak areas, respectively. The essential oils consisted mainly of alcohols (29.4 % and 1.6 %), ketone (21.7 % and 18.6 %) and hydrocarbons (13.1 % and 57.6 %). The major compound of the essential oils was 3-octanone (21.7 % and 18.6 %), respectively. The inhibitory effects of the essential oils of C. rangiformis and C. furcata, were tested against seven bacterial species using the disc-diffusion method and C. rangiformis oil exhibited the antimicrobial and antifungal activity against Enterococcus faecalis and Candida albicans (MIC = 306.2 ?g/?L, each), whereas, C. furcata oil showed only antifungal activity against the pathogenic yeast C. albicans (MIC = 784.4 ?g/?L)

Comparative essential oil analysis of Calendula arvensis L. extracted by hydrodistillation and microwave distillation and antimicrobial activities

The present study was to investigate the influence of the extraction methods on yield and chemical composition of the essential oil of Calendula arvensis L. The volatiles of C. arvensis have been isolated by hydrodistillation (HD) and microwave distillation (MD). The compositions of the essential oils were characterized by GC-FID and GC-MS. A total of 45 and 44 compounds were identified, constituting over 88.3 % and 84.8 % of oil composition of C. arvensis, respectively. Sesquiterpenes (HD: 30.5 % and MD: 23.4 %) and monoterpene compounds (HD: 26.3 % and MD: 24.3 %) were shown to be the main group of volatiles. The major terpene constituent of the essential oils of C. arvensis was a-selinene (HD, 16.0 % and MD, 0.0 %), ?-pinene (HD, 11.9 % and MD, 12.3 %), (Z)-a-santalol (HD, 8.2 % and MD, 7.4 %), d-amorphene (HD, 0.0 % and MD, 8.0 %), (Z)-sesquilavandulol (HD, 4.8 % and MD, 0.0 %), 7-epi-silphiperfol-5-ene (HD, 2.6 % and MD, 3.7 %), viridiflorene (HD, 2.5 % and MD, 1.7 %) and ?-pinene (HD, 1.8 % and MD, 2.4 %). Comparative study showed that the amount of total volatiles (88.3 % and 84.8 %) and the identified constituent (45 and 44) were found to be similar in both HD and MD of C. arvensis. The terpenoid contents (HD: 73.5 % and MD: 65.3 %) were greater in HD of C. arvensis. The antimicrobial activities of the isolated essential oils, hexane, ether and methanolic extracts of the plant were also investigated and only the essential oil (HD) and methanolic extract showed moderate antibacterial activities against Staphylococcus aureus and Bacillus cereus with in the range of 105-210 ìg, respectively. But all the extract showed good antituberculose activity against Mycobacterium smegmatis (13.2-62.5 ìg)

Antimicrobial activity and chemical composition of the essential oils of mosses (Hylocomium splendens (Hedw.) Schimp. and Leucodon sciuroides (Hedw.) Schwägr.) growing in Turkey

In the present work, the volatiles of mosses [Hylocomium splendens (Hedw.) Schimp. (Hylocomiaceae) and Leucodon sciuroides (Hedw.) Schwägr. (Leucodontaceae)] have been investigated by GC-FID and GC/MS. Fifty-eight compounds in the oil of H. splendens, representing 75.4%, and 41 compounds in the oil of L. sciuroides, representing 87.6%, were identified. The major components were found to be ? -pinene (11.6%) and a-pinene (8.9%) in the oil of H. splendens, and nonanal (26.8%) and heptanal (13.7%) in the oil of L. sciuroides. The essential oil of H. splendens was rich in monoterpenes (30.8%), and aldehydes (49.9%) were the major constituents in the oil of L. sciuroides. The antimicrobial activities of the isolated essential oils of the mosses were also investigated. The essential oil of H. splendens showed antibacterial activities against Escherichia coli, Yersinia pseudotuberculosis, Staphylococcus aureus, Enterococcus faecalis, Bacillus cereus, Mycobacterium smegmatis, and the fungus Candida albicans with minimum inhibition concentrations in the range of 428-857 ?g/mL, respectively. The oil of L. sciuroides only showed activity against fungus C. albicans (711 ?g/mL). © TÜBITAK