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During formation of the stratum corneum (SC) barrier, terminally differentiated keratinocytes continue their maturation process within the dead superficial epidermal layer. Morphological studies of isolated human corneocytes have revealed differences between cornified envelopes purified from the deep and superficial SC. We used atomic force microscopy (AFM) to measure the mechanical properties of native human corneocytes harvested by tape-stripping from different SC depths. Various conditions of data acquisition have been tested and optimized, in order to obtain exploitable and reproducible results.
Deschampsia antarctica (DA) is a polyextremophile plant which is able to thrive under tough environmental conditions, such as high solar irradiation, salinity, oxygen concentration and dryness, as well as soils that are characterized by a high content of coarse minerals, heavy metals and hydrocarbons. Dioxins are ubiquitous environmental contaminants that have attracted toxicological interest because of their unique mechanism of action causing of potential risk for human health. This mechanism involves the aryl hydrocarbon receptor (AhR) which has proven to have an integral regulatory role in several physiological processes.
The development and organization of human skin barrier function after birth is a delicate adaptive process leading to a mature stratum corneum (SC) at the end of infancy. Before SC complete formation, skin is considered as immature and clinical data have demonstrated its fragility and sensitivity towards the domestic water hardness increasing the atopic dermatitis risk due to surfactants deposition. An experimental in vitro model recapitulating immature skin features has been developed based on a Reconstructed Human Epidermis (RHE) used at early stage of differentiation (day 12).
Calciphylaxis is an ulcerative skin disease with high mortality that typically requires multidisciplinary management. Although calciphylaxis can be histopathologically confirmed by skin biopsy, the necessity of a biopsy as a prerequisite for diagnosis is debated. A positive biopsy helps exclude mimics of calciphylaxis and avoids unnecessary treatment. However, it is thought that skin biopsy carries low sensitivity and may lead to further areas of necrosis or superimposed infection in this patient cohort.
As the use of immune checkpoint inhibitors (ICI) for the treatment of advanced malignancies continues to rise, so too will rates of immune-related adverse events (irAEs). Serious dermatologic irAEs requiring inpatient care and prompting changes in management can occur with ICIs. In this retrospective study, we aim to characterize such dermatologic irAEs requiring hospital admission and elucidate the impact of dermatology consultation in their management. Specifically, we identified 16 patients who were admitted to Massachusetts General Hospital from 2011 to 2017 with suspected dermatologic irAE.
Standardized patient-reported outcome assessments can provide important insight into the burden of atopic dermatitis (AD). However, there is currently a lack of standardization for the assessment of burden in AD. We sought to determine the construct validity, internal consistency, differential reporting by age and sex, internal responsiveness, floor or ceiling effects, and feasibility of Dermatology Life Quality Index (DLQI), ItchyQOL, and 5-dimensions (5-D) itch scales for assessing AD in adults and compare their performance.
Skin biopsies are used widely to diagnose and occasionally treat various dermatologic conditions. They are often quick procedures, do not require the use of many tools and can be performed in almost any medical setting. We sought to determine the incidence of skin biopsies for patients in emergency departments (EDs) in the United States and the impact of an institution’s teaching status on these trends. Using the Nationwide Emergency Department Sample database, provided by the Healthcare Cost and Utilization Project, we identified 186,834 visits involving skin biopsy procedures (ICD-9 Procedure Code 86.11) from 2006 to 2014 in EDs in the US.
In recent years, the concept that skin aging progresses by multiple factors due to environmental and psychological stresses has been proposed.1) This concept is defined as “Exposome” that affects human individuals from conception to death as well as the responses of the human body to these factors that lead to biological and clinical signs of skin aging. Especially, it is well known that chronic psychological stress and the quality of sleep are involved in changes of skin conditions via effects on the autonomic nerve system (ANS).
Background: Sonic Hedgehog Inhibitors (SHHi) provide an additional treatment option for basal cell carcinomas (BCC), especially for metastatic or locally advanced BCC. However, studies have been heterogeneous and underpowered to evaluate outcomes. Objective: To determine the efficacy and safety of SHHi, as a class of molecules, for treating BCC, and to compare them individually. Methods: We performed a PRISMA-compliant systematic review of articles and trials followed by a meta-analysis. Results: Eighteen articles were included in our meta-analysis; sixteen articles were combined for efficacy and sixteen for safety.
Basal cell carcinoma (BCC) is thought to have a very low risk of disease-related poor outcomes [DROs: local recurrence (LR), metastasis and/or death (M/D)] but the topic is not well-studied. The objectives of this retrospective cohort study were to identify risk factors independently associated with DROs in large (≥2cm) BCC and to develop a tumor (T) classification system for BCC. Primary BCCs histologically confirmed at two academic hospitals between 2000 and 2009 were retrospectively screened for tumor diameter.
BACKGROUND: Although the lip is considered a high-risk location in cutaneous squamous cell carcinoma (cSCC), it has not been established whether this risk stems from vermilion or cutaneous locations or both. OBJECTIVE: To compare differences in risks of local recurrence, nodal metastasis, distant metastasis, disease-specific death, and all-cause death from cSCCs on the vermilion vs cutaneous lip. METHODS: Retrospective cohort study of 303 patients with 310 primary cSCCs of the lip (138 cutaneous, 172 vermilion) diagnosed between 2000-2015 at 2 academic tertiary care centers in Boston, MA.
Pain has been suggested to be a major symptom for atopic dermatitis (AD) patients (pts). Dupilumab is approved in the EU, USA, Japan, and other countries for treatment of adults with inadequately controlled moderate-to-severe AD. Here we describe the burden related to symptoms of pain/discomfort in moderate-to-severe AD pts, and dupilumab efficacy in relieving these symptoms (assessed by EuroQol five dimensions questionnaire [EQ-5D]) across multiple phase 3 trials (LIBERTY AD SOLO 1&2 [pooled]: NCT02277743/NCT02277769; LIBERTY AD CHRONOS: NCT02260986; LIBERTY AD CAFÉ: NCT02755649).
Introduction: Vulvovaginal Lichen Planus (VLP) is a rare but debilitating condition. Its clinical presentation can be significantly heterogenous, the condition is underdiagnosed and its clinical sequale can be severe. Patients often experience a delay in diagnosis and effective treatment that carries a significant impact on QOL as no evidence based diagnostic criterion have been widely adopted by clinicians. Materials and methods: A retrospective analysis of 548 patients who were treated for VLP at a private vulval dermatology clinic in Sydney, Australia was conducted.
Management of basal cell carcinoma (BCC) varies by histopathologic subtype; however, several studies have shown discordance in BCC subtype on initial biopsy compared to final tumor characteristics as seen both on Mohs micrographic surgery (MMS) and surgical excisions. This is concerning, as underdiagnosis of aggressive subtypes can lead to inadequate treatment. Based on our experience at a tertiary academic center, we hypothesized that BCCs of the head and neck tend to be characterized by particularly aggressive subtypes that are at increased risk of being missed on initial biopsy.
The immune pathways required for autoreactive T cell activation in alopecia areata (AA) have been recently proposed to involve the common gamma chain (gc) cytokines IL-2, IL-9 and IL-15, which have been shown to be upregulated in animal models of AA and in human biopsies of AA lesions. BNZ-1 is a PEGylated peptide that binds to the γc receptor and selectively inhibits IL-2/IL-9/IL-15 signaling, which shuts off the JAK-STAT, PI3K/Akt/mTOR and Raf/ERK/MAPK pathways. BNZ-1 has been shown to be effective at reversing hair loss in a humanized mouse model of AA and has undergone extensive preclinical safety testing to open an US IND.
Oral spironolactone (S) is increasingly utilized as an off-label acne therapy in adult women. Although the package insert indicates that potassium (K) monitoring should be performed for FDA-approved indications, it has been reported to be of low usefulness in otherwise healthy women 18-45 years of age treated with S for acne. This study aims to determine, from a dermatology patient population, the incidence of HK between women ≤45yo and women >45yo who have acne and are exposed to S. The Northwestern Medicine Enterprise Data Warehouse, a medical record data repository (>5 million patients), provided data for all females with acne (ICD 9/10:706.1/L70.0) seen in Dermatology (Jan 2006 - Oct 2016), aged 18-89yo, with at least 1 serum K within 12 months both pre- and post-initiation of S exposure.
Vesicants including mustards and arsenicals were developed as chemical weapons to debilitate the military and civilian populations during World War-I/II as these chemicals cause rapid and severe painful inflammatory and blistering responses. The molecular pathogenesis and characterization of mechanism of skin injury following exposure to these devastating agents is largely unknown. We characterized the progressive skin damage following exposure to arsenical lewisite in a validated murine model. H & E-stained sections of lewisite-exposed skin revealed highly inflamed areas with inflammatory cell infiltration, which could be visualized as early as 6 h.
Port Wine stains are very difficult to treat. Laser can decrease partially the vascular lesions. Grape seed antioxidants (Resveratrol and procyanidines) have been shown to decreased the VEGF (1)and to decrease hemangiomas in vitro (2). We assessed the eficacity and safety of oral Chilean Grape seed antioxidants in two patients with extensive facial port wine stains. Two patients were taking 500 mg twice a day for one month. A clinical, a photographic and subjective assessment were done. A decrease of 18% was noticed and patients felt that they have improved after using the oral grape seed antioxidants.
The introduction of immune checkpoint inhibitors (CI) has set a new milestone in treating stage IV cancers including melanoma and non-small cell lung cancer. However, they entail immune-related adverse events that can affect all organs. Their etiology remains poorly understood and may be a result of shared antigen targets in cancer and organs. Here, we explored whether autoantibodies against keratinocyte specific antigens promote the development of autoimmune adverse events in non-small cell lung cancer (NSCLC) patients.
Long-courses of antibiotics are commonly used for treatment of hidradenitis suppurativa (HS), raising concern for antibiotic resistance. We sought to examine the effect of antiseptic washes on the frequency of antibiotic resistance in HS lesions. A cross-sectional analysis was done on patients with HS at two tertiary care centers from 2005 to 2018. We abstracted data from the electronic records of 80 patients who had 121 total wound or tissue culture specimens from HS lesions including the culture results and use of oral or topical antibiotics and antiseptic cleansers (chlorhexidine, etc) within 4 weeks prior to culture.