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Augustin and colleagues present a detailed investigation of the distribution of body sites affected by psoriasis in adult German patients with psoriasis under the care of dermatologists. Patients self-completed a grid indicating areas of involvement, with 96% providing complete grid data. Of the 2009 patients, 19% had psoriatic arthritis, 65% had scalp involvement, 36% had nail involvement and 41% reported an affected first-degree relative. In a linear regression analysis, the strongest predictors of reductions in health-related quality of life, measured by the Dermatology Life Quality Index, were involvement of the hands, arms, genitals, neck, scalp and nails.
The Research Techniques Made Simple (RTMS) series of the Journal of Investigative Dermatology (JID) was created to be an educational tool for scientists and clinicians training for a lifelong career in Dermatology. Since its inception in the fall of 2012, 84 articles have been written and published monthly online, in seven volumes of annual reprints, and in each print issue of the JID since 2018. RTMS articles come as a packet that includes the article itself, a supplemental Powerpoint presentation to allow easy adaptation for journal clubs and teaching, and at-a-glance summary points.
The skin employs multiple immune defense strategies, including the production of antimicrobial peptides, to manage interactions with skin microbiota and prevent infection. These interactions are governed by not only the microbiota and environmental factors but also by dietary intake, as vitamin A deficiency is associated with increased susceptibility to skin infection. Harris and colleagues recently reported that resistin-like molecule α (RELMα) is an antibacterial protein that is expressed in the skin in response to the microbiota.
To assess the impact of disease severity on racial and ethnic differences in healthcare utilization for pediatric atopic dermatitis (AD), Wan and colleagues performed a longitudinal study involving 7,522 white, black, and Hispanic children from the United States. Black and Hispanic children were more likely than white children to visit a medical provider for AD, and these increased odds were similar across all levels of disease control and independent of sociodemographic factors. Specifically, black and Hispanic children more frequently used the emergency department for these visits than white children, and black patients with poor disease control were less likely to visit a dermatologist.
Dermatology is an interdisciplinary specialty that requires incorporation of expertise from multiple backgrounds, including pathology, immunology, genetics, cell and developmental biology, biomedical engineering, and cancer biology, to better understand the mechanisms underlying conditions arising in our patients. It is critically important for dermatology training programs to reflect this broad and ever-expanding array of topics to prepare the next generation of clinicians and basic scientists for a lifetime of encountering new challenges.
Editorial note: Welcome to the Journal of Investigative Dermatology (JID) Cells to Surgery Quiz. In this monthly online-only quiz, the ﬁrst question (“What is your diagnosis?”) relates to the clinical image shown, while additional questions concern the ﬁndings reported in the JID article by Kuonen et al. (2019) (https://doi.org/10.1016/j.jid.2018.11.035).
Editorial note: Welcome to the Journal of Investigative Dermatology (JID) Snapshot Dx Quiz. In this monthly online-only quiz, the ﬁrst question (“What is your diagnosis?”) relates to the clinical image shown, while additional questions concern the ﬁndings reported in the JID article by Murer et al (2019) (https://doi.org/10.1016/j.jid.2018.11.028).
Papulopustular rosacea (PPR) is a chronic inflammatory skin disease which manifests as red, inflammatory papules or pustules predominantly on the facial region. Although the pathogenesis of PPR is not well understood, an over-reactive inflammatory response plays a role, resulting in altered vasculature and skin sensitivity. Although previous studies have assessed RNA expression or immunohistochemistry staining in tissue, to our knowledge this is the first-time quantitative protein analysis of PPR tissue has been performed.
Skin resident memory T cells (TRMs) are a sessile population of cells implicated in various autoimmune inflammatory diseases including psoriasis (PSO). Long-lived CD8+ TRMs (CD103+) that produce IL-17A in psoriatic skin are thought to be responsible for the localized relapsing nature of the disease. Knowledge of the relative contribution of subsets of TRMs and other effector T cells to the pathogenesis of psoriasis remains limited. Here, we used immunophenotyping by multiparameter flow cytometry to characterize T cell subsets in lesional skin from PSO patients, and compared to those in matched non-lesional skin (n=20).
Psoriasis is an immune-mediated disease thought to be driven by heightened Th17 and Th1 responses. Secukinumab is an IL17A inhibitor used for the treatment of psoriasis. We aimed to understand the impact of secukinumab on psoriatic whole skin tissue as well as specific skin immune cell populations. We treated 15 psoriasis patients with secukinumab and characterized the response of whole skin lesional tissue and cutaneous T cell subsets (CD4+ T regulatory cells (Tregs), CD4+ T and CD8+ T effector cells) to treatment.
We previously reported that the expression of CX3CL1 and its receptor, CX3CR1 was increased in patients with systemic sclerosis (SSc). In this study, we assessed the preclinical efficacy of an anti-CX3CL1 monoclonal antibody (mAb) in SSc. Cultured human dermal fibroblasts were used to evaluate the direct effect of anti-CX3CL1mAb on fibroblasts. In addition, bleomycin and growth factor-induced SSc models were used to investigate the effect of anti-CX3CL1mAb on leukocyte infiltration, collagen deposition, and vascular damage in the skin.
Generalized pustular psoriasis (GPP) is a rare, life-threatening disease, characterized by recurrent flares of pustular, erythematous rashes, with a strong genetic linkage to the IL-36 pathway. The efficacy and safety of a single, open-label, intravenous dose of BI 655130 (10 mg/kg), an anti-IL-36R monoclonal antibody, was assessed in a Phase I trial (NCT02978690) in 7 patients presenting with a moderate-to-severe GPP flare. To characterize the response to BI 655130 at a molecular level, biomarkers in lesional skin and blood were analyzed.
CD8+ cutaneous lymphomas include a variety of rare cutaneous T-cell lymphomas (CTCL) and lymphoproliferative disorders (LPD) with distinctly different prognoses, clinicopathological overlap, and resistance to current therapeutic strategies. Improved diagnostic tools and therapeutic options are needed. To evaluate C-C chemokine receptor 4 (CCR4) expression in CD8+ CTCL/LPDs as a diagnostic and potential therapeutic biomarker we performed CCR4 immunohistochemistry (IHC) on formalin-fixed paraffin-embedded skin sections from 41 patients with various CD8+ CTCL/LPDs (n=49 biopsies).
Skin processes excellent regeneration properties allowing its rapid healing upon dermal injury. If wounds fail to heal in an orderly and timely manner, chronic ulcers develop. To test the potential of innovate therapies to promote wound repair, relevant wound infection models are needed. Current research is mainly conducted on animal models, which often limits direct transferability to human and poses ethic issues. These limitations can be overcome by using a proprietary ex vivo human skin model, HypoSkin®, produced with leftovers from esthetic surgery.
Abnormal angiogenesis and dysfunction of macrophage polarization in diabetic skin ulcers leads to non-healing wound. Huiyang Shengji Extract (HSE)is a traditional Chinese medicine prescribed for the treatment of chronic wounds. This study aims to investigate the effect and molecular mechanism of HSE on wound healing of diabetic mice. Diabetic db/db mice were operated with full-thickness excision, with wound treated externally by HSE. The results showed that HSE reduces the wound area on days 7 and 14; Compared with the model group on day 10, the local blood flow of the wound of HSE group was significantly increased according to Doppler ultrasound imaging.
It is known that the main bioenergetic pathway in skin is the anaerobic glycolysis. Thus, glucose consumption and a high production of lactate are a proof of an active metabolism in skin. This has never been demonstrated in an ex vivo human skin model before. NativeSkin® is an ex vivo human skin model, composed of the two upper skin layers. The skin explant is embedded in a proprietary gel-like matrix with epidermal surface left in direct contact with the air. The system is mounted into cell culture inserts and maintained in standard cell culture conditions.
Advanced age and ultraviolet light exposure are two important epidemiologic risk factors for the development of cutaneous malignancy. Ultraviolet light is a known mutagen, and while multiple reports describe the clonal expansion of tumor-associated mutations in clinically normal skin, how these cells switch to malignancy is unclear and may involve epigenetic mechanisms. Multiple reports describe genomic regions of DNA hypomethylation related to increased age and sun exposure in the epidermis of human volunteers, some of which were preserved in cutaneous squamous cell carcinoma samples.