PE573 Atopic Dermatitis (Eczema)
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Autoimmune Associations of Alopecia Areata in Pediatric Population - a Study in Tertiary Care Centre
IP Indian Journal of Clinical and Experimental Dermatology 2020;6(1):41–44 Content available at: iponlinejournal.com IP Indian Journal of Clinical and Experimental Dermatology Journal homepage: www.innovativepublication.com Original Research Article Autoimmune associations of alopecia areata in pediatric population - A study in tertiary care centre Sagar Nawani1, Teki Satyasri1,*, G. Narasimharao Netha1, G Rammohan1, Bhumesh Kumar1 1Dept. of Dermatology, Venereology & Leprosy, Gandhi Medical College, Secunderabad, Telangana, India ARTICLEINFO ABSTRACT Article history: Alopecia areata (AA) is second most common disease leading to non scarring alopecia . It occurs in Received 21-01-2020 many patterns and can occur on any hair bearing site of the body. Many factors like family history, Accepted 24-02-2020 autoimmune conditions and environment play a major role in its etio-pathogenesis. Histopathology shows Available online 29-04-2020 bulbar lymphocytes surrounding either terminal hair or vellus hair resembling ”swarm of bees” appearance depending on chronicity of alopecia areata. Alopecia areata in children is frequently seen. Pediatric AA has been associated with atopy, thyroid abnormalities and a positive family history. We have done a study to Keywords: find out if there is any association between alopecia areata and other auto immune diseases in children. This Alopecia areata study is an observational study conducted in 100 children with AA to determine any associated autoimmune Auto immunity conditions in them. SALT score helps to assess severity of alopecia areata. Severity of alopecia areata was Pediatric population assessed by SALT score-1. S1- less than 25% of hairloss, 2. S2- 25-49% of hairloss, 3. 3.S3- 50-74% of hairloss. -
The Tumor Necrosis Factor Superfamily Molecule LIGHT Promotes Keratinocyte Activity and Skin Fibrosis Rana Herro1, Ricardo Da S
ORIGINAL ARTICLE The Tumor Necrosis Factor Superfamily Molecule LIGHT Promotes Keratinocyte Activity and Skin Fibrosis Rana Herro1, Ricardo Da S. Antunes1, Amelia R. Aguilera1, Koji Tamada2 and Michael Croft1 Several inflammatory diseases including scleroderma and atopic dermatitis display dermal thickening, epidermal hypertrophy, or excessive accumulation of collagen. Factors that might promote these features are of interest for clinical therapy. We previously reported that LIGHT, a TNF superfamily molecule, mediated collagen deposition in the lungs in response to allergen. We therefore tested whether LIGHT might similarly promote collagen accumulation and features of skin fibrosis. Strikingly, injection of recombinant soluble LIGHT into naive mice, either subcutaneously or systemically, promoted collagen deposition in the skin and dermal and epidermal thickening. This replicated the activity of bleomycin, an antibiotic that has been previously used in models of scleroderma in mice. Moreover skin fibrosis induced by bleomycin was dependent on endogenous LIGHT activity. The action of LIGHT in vivo was mediated via both of its receptors, HVEM and LTβR, and was dependent on the innate cytokine TSLP and TGF-β. Furthermore, we found that HVEM and LTβR were expressed on human epidermal keratinocytes and that LIGHT could directly promote TSLP expression in these cells. We reveal an unappreciated activity of LIGHT on keratinocytes and suggest that LIGHT may be an important mediator of skin inflammation and fibrosis in diseases such as scleroderma -
Seborrheic Dermatitis: an Overview ROBERT A
Seborrheic Dermatitis: An Overview ROBERT A. SCHWARTZ, M.D., M.P.H., CHRISTOPHER A. JANUSZ, M.D., and CAMILA K. JANNIGER, M.D. University of Medicine and Dentistry at New Jersey-New Jersey Medical School, Newark, New Jersey Seborrheic dermatitis affects the scalp, central face, and anterior chest. In adolescents and adults, it often presents as scalp scaling (dandruff). Seborrheic dermatitis also may cause mild to marked erythema of the nasolabial fold, often with scaling. Stress can cause flare-ups. The scales are greasy, not dry, as commonly thought. An uncommon generalized form in infants may be linked to immunodeficiencies. Topical therapy primarily consists of antifungal agents and low-potency steroids. New topical calcineurin inhibitors (immunomodulators) sometimes are administered. (Am Fam Physician 2006;74:125-30. Copyright © 2006 American Academy of Family Physicians.) eborrheic dermatitis can affect patients levels, fungal infections, nutritional deficits, from infancy to old age.1-3 The con- neurogenic factors) are associated with the dition most commonly occurs in condition. The possible hormonal link may infants within the first three months explain why the condition appears in infancy, S of life and in adults at 30 to 60 years of age. In disappears spontaneously, then reappears adolescents and adults, it usually presents as more prominently after puberty. A more scalp scaling (dandruff) or as mild to marked causal link seems to exist between seborrheic erythema of the nasolabial fold during times dermatitis and the proliferation of Malassezia of stress or sleep deprivation. The latter type species (e.g., Malassezia furfur, Malassezia tends to affect men more often than women ovalis) found in normal dimorphic human and often is precipitated by emotional stress. -
Pompholyx Factsheet Pompholyx Eczema (Also Known As Dyshidrotic Eczema/Dermatitis) Is a Type of Eczema That Usually Affects the Hands and Feet
12 Pompholyx factsheet Pompholyx eczema (also known as dyshidrotic eczema/dermatitis) is a type of eczema that usually affects the hands and feet. In most cases, pompholyx eczema involves the development of intensely itchy, watery blisters, mostly affecting the sides of the fingers, the palms of the hands and soles of the feet. Some people have pompholyx eczema on their hands and/or feet with other types of eczema elsewhere on the body. This condition can occur at any age but is usually seen in adults under 40, and is more common in women. The skin is initially very itchy with a burning sensation of heat and prickling in the palms and/or soles. Then comes a sudden crop of small blisters (vesicles), which turn into bigger weepy blisters, which can become infected, causing redness, pain, swelling and pustules. There is often subsequent peeling as the skin dries out, and then the skin can become red and dry with painful cracks (skin fissures). Pompholyx eczema can also affect the nail folds and skin around the nails, causing swelling (paronychia). What causes it? A reaction could be the result of contact with potential irritants such as soap, detergents, solvents, acids/alkalis, The exact causes of pompholyx eczema are not known, chemicals and soil, causing irritant contact dermatitis. Or although it is thought that factors such as stress, there could be an allergic reaction to a substance that is sensitivity to metal compounds (such as nickel, cobalt or not commonly regarded as an irritant, such as rubber or chromate), heat and sweating can aggravate this nickel, causing allergic contact dermatitis. -
Atopic Dermatitis 101 for Adults
TRIGGER TRACKER Atopic Dermatitis 101 for Adults WHAT IS ATOPIC DERMATITIS? IS THERE A CURE? Atopic dermatitis (AD) is the most common type There is no cure for of eczema. It often appears as a red, itchy rash or atopic dermatitis yet, dry, scaly patches on the skin. AD usually begins but there are treatments in infancy or childhood but can develop at any available and more are on the way. point in a person’s lifetime. It commonly shows up on the face, inside of the elbows or behind the WHAT ARE MY TREATMENT OPTIONS? knees, but it can appear anywhere on the body. It is important to have a regular schedule with AD care that includes bathing with a gentle IS IT CONTAGIOUS ? cleanser and moisturizing to lock water into the You can’t catch atopic dermatitis or spread it to skin and repair the skin barrier. Moisturized skin others. helps control flares by combating dryness and keeping out irritants and allergens. WHAT CAUSED IT? Depending on severity of symptoms and age, AD While the exact cause is unknown, researchers do treatments include lifestyle changes, over-the- know that people develop atopic dermatitis counter (OTC) and natural remedies, prescription because of a combination of genes and a trigger. topical medications, which are applied to the People with AD tend to have an over-reactive immune system that when triggered by skin; biologics, given by injection; something outside or inside the body, responds immunosuppressants, usually taken by mouth in by producing inflammation. It is this inflammation the form of a pill; and phototherapy, a form of that causes red, itchy and painful skin symptoms. -
Effectiveness of Medium-Dose Ultraviolet A1 Phototherapy in Localized Scleroderma
Pharmacology and therapeutics Effectiveness of medium-dose ultraviolet A1 phototherapy in localized scleroderma Ozlem Su1, MD, Nahide Onsun1, MD, Hulya Kapran Onay2, MD, Yeliz Erdemoglu1, MD, Dilek Biyik Ozkaya1, MD, Filiz Cebeci1, MD, and Adnan Somay3, MD 1Department of Dermatology, Abstract Bezmialem Vakif University, Faculty of Background Recently, ultraviolet (UV) A1 phototherapy has been suggested as an effec- 2 Medicine, Neoson Imaging Center, tive treatment for localized scleroderma (LS); however, the optimal dose of UVA1 still has Radiology, and 3Department of not been determined. Pathology, Vakif Gureba Teaching and 2 Research Hospital, Istanbul, Turkey Objective We aimed to evaluate the therapeutic effectiveness of medium-dose (30 J/cm ) UVA1 phototherapy and to show that 13 MHz ultrasound is a valuable tool for assessing Correspondence the results of UVA1 phototherapy in LS. Ozlem Su, MD Methods Thirty-five patients with LS were treated with medium-dose (30 J/cm2) UVA1. Sıgırtmac Sok. No. 21 B blok d. 7 In total, 30–45 treatments and 900–1350 J/cm2 cumulative UVA1 doses were evaluated by Osmaniye Bakirkoy clinical scoring in all patients. In 14 patients, skin thickness was also determined by Istanbul 13 MHz ultrasound examination. Turkey Results In all patients, medium-dose UVA1 therapy softened sclerotic plaques, and E-mail: [email protected] marked clinical improvement was observed in 29 of 35 (82. 85%) patients. Ultrasound mea- surements showed that skin thickness was significantly reduced. No side effects were Conflicts of interest: None. observed during or after treatment. Conclusion Medium-dose UVA1 phototherapy is a highly effective, safe, and well-tolerated therapeutic modality for treatment of all types of LS. -
Decreased Adhesion Molecules Expression on Granuloma Forming
THE EGYPTIAN JOURNAL OF IMMUNOLOGY Vol. 22 (1), 2015 Page: 29-40 Level of IL-16 and Reticulated Platelets Percentage during the Clinical Course of Immune Thrombocytopenic Purpura in Children 1Reem R. Abd El-Glil, 2Effat H. Assar Departments of 1Microbiology & Immunology and 2Pediatric, Faculty of Medicine, Benha University, Benha, Egypt. Immune thrombocytopenic purpura (ITP) is an immune-mediated acquired disease with transient or persistent decrease of thrombocytes number in the blood. Cytokines play important roles in the immune regulation and are known to be deregulated in autoimmune diseases. This study aimed to investigate serum IL-16 levels in relation to reticulated platelets in children with ITP and platelet count. Twenty six children with ITP (11 with newly diagnosed ITP, 9 with persistent ITP and 6 with chronic ITP) and 12 age-matched healthy children controls were studied. Serum level of IL-16 and reticulated platelets count were assessed by Enzyme Linked Immunosorbent Assay (ELISA) and flow cytometry respectively. Serum IL-16 levels were significantly higher in patients as compared to controls (P<0.001).Within patients, the levels were higher in newly diagnosed compared to persistent and chronic ITP (P<0.01) and (P<0.001) respectively. IL-16 levels were also significantly higher in persistent ITP compared to chronic ITP (P<0.001). Reticulated platelets were also elevated in patients compared to controls and the increase was significant in newly diagnosed group (P<0.05). Negative correlation was found between IL-16 level and reticulated platelets and platelets counts (r=-0.284, P=0.028, r=0.274 P=0.25) respectively. -
Allergic Contact Dermatitis Handout
#30: ALLERGIC CONTACT DERMATITIS PATIENT PERSPECTIVES Allergic contact dermatitis Contact dermatitis is an itchy rash that is caused by something touching (contacting) your skin. The rash is usually red, bumpy, and itchy. Sometimes there are blisters filled with fluid. THERE ARE TWO TYPES OF CONTACT DERMATITIS: COMMON FORMS OF ALLERGIC CONTACT DERMATITIS: 1. Some things that contact skin are very irritating and will cause a rash in most people. This rash is called irritant contact dermatitis. Examples are acids, soaps, cold weather, and friction. » ALLERGIC CONTACT DERMATITIS TO HOMEMADE SLIME 2. Some things that touch your skin give you a rash because you are allergic to them. This rash is called allergic contact dermatitis. » Slime is a homemade gooey These are items that do not bother everyone’s skin. They only substance that many young people cause a rash in people who are allergic to those items. make and play with. » There are several recipes for making WHAT ARE COMMON CAUSES OF ALLERGIC slime. Common ingredients include CONTACT DERMATITIS IN CHILDREN AND boric acid, contact lens solution, WHERE ARE THEY FOUND? laundry detergent, shaving cream, and school glue. Many ingredients » Homemade slime: often irritation (irritant contact dermatitis) being used can cause irritation results from soap or detergent but can have allergic contact (“irritant contact dermatitis”) and some dermatitis to glues and other ingredients can cause allergic contact dermatitis. » Plants: poison ivy, poison oak, poison sumac » Children playing with slime may get » Metals (especially nickel): snaps, jewelry, an itchy rash on their hands. There belt buckles, electronics, toys can be blisters, flaking, peeling, and cracking. -
Drug Eruptions
DRUG ERUPTIONS http://www.aocd.org A drug eruption is an adverse skin reaction to a drug. Many medications can cause reactions, especially antimicrobial agents, sulfa drugs, NSAIDs, chemotherapy agents, anticonvulsants, and psychotropic drugs. Drug eruptions can imitate a variety of other skin conditions and therefore should be considered in any patient taking medications or that has changed medications. The onset of drug eruptions is usually within 2 weeks of beginning a new drug or within days if it is due to re-exposure to a certain drug. Itching is the most common symptom. Drug eruptions occur in approximately 2-5% of hospitalized patients and in greater than 1% of the outpatient population. Adverse reactions to drugs are more prevalent in women, in the elderly, and in immunocompromised patients. Drug eruptions may be immunologically or non-immunologically mediated. There are 4 types of immunologically mediated reactions, with Type IV being the most common. Type I is immunoglobulin-E dependent and can result in anaphylaxis, angioedema, and urticaria. Type II is cytotoxic and can result in purpura. Type III reactions are immune complex reactions which can result in vasculitis and type IV is a delayed-type reaction which results in contact dermatitis and photoallergic reactions. This is important as different medications are associated with different types of reactions. For example, insulin is related with type I reactions whereas penicillin, cephalosporins, and sulfonamides cause type II reactions. Quinines and salicylates can cause type III reactions and topical medications such as neomycin can cause type IV reactions. The most common drugs that may potentially cause drug eruptions include amoxicillin, trimethoprim sulfamethoxazole, ampicillin, penicillin, cephalosporins, quinidine and gentamicin sulfate. -
Dupilumab Is a Predominant Treatment for Recalcitrant Bullous Pemphigoid
Somato Publications ISSN: 2688-1071 Archives of Clinical Case Reports Case Report Dupilumab is a Predominant Treatment for Recalcitrant Bullous Pemphigoid Nozomi Yonei* Division of Dermatology, Naga Municipal Hospital, 1282 Uchita, Kinokawa, Wakayama 649-6414, Japan *Address for Correspondence: Nozomi Yonei, Division of Dermatology, Naga Municipal Hospital, 1282 Uchita, Kinokawa, Wakayama 649-6414, Japan, Tel: +81-736-77-2019; E-mail: [email protected] Received: 01 February 2021; Accepted: 22 February 2021; Published: 24 February 2021 Citation of this article: Nozomi Yonei. (2020) Dupilumab is a Predominant Treatment for Recalcitrant Bullous Pemphigoid. Arch Clin Case Rep, 4(1): 01-04. Copyright: © 2021 Nozomi Yonei. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Bullous pemphigoid is occasionally recalcitrant to established medications. Our 72-year-old male patient was treated with established medications such as systemic corticosteroid (prednisone 1.3_0.7mg/kg), methylprednisolone pulse therapy, 7 up, and many complications such as aspiratory pneumonia, chronic urinary infection, hypoalbuminemia were observed. doses of monthly intravenous immunoglobulin, cyclosporine. During tapering of prednisone, the disease activity easily flared Given the patient’s severe disease status and treatment limitations, we introduced dupilumab expecting Th2-suppressive effect, according to the dosing regimen approved for atopic dermatitis. After 2 months of dupilumab therapy, BPDAI (Bullous Pemphigoid Disease Area Index) score halved, and after 3 months, he accomplished the clearance of the lesions. A place- bo-controlled phase 3 clinical trial of dupilumab for severe BP is now under way, and it is expected that the effectiveness of dupilumab for BP will be proved in the near future. -
PE2342 Seborrheic Dermatitis
Seborrheic Dermatitis What is seborrheic Seborrheic dermatitis is a common skin condition. It causes redness, dermatitis? scaling, or flaky patches in infants, teens and adults. What parts of the • Scalp (this is known as dandruff, or cradle cap in infants) body are usually • Eyebrows affected? • Eyelids • Ears • Nose • Skin fold areas (such as armpits or thighs) What causes The cause of seborrheic dermatitis is not known. Some believe that it is seborrheic caused by an overgrowth of yeast. It is not related to what you eat and it is dermatitis? not contagious. Stress and sickness often make seborrheic dermatitis symptoms worse, but they do not cause it. Symptoms can get better or worse for no reason. What are the Symptoms include: symptoms of • Redness seborrheic • Itching dermatitis? • Scaly patches on your skin that may look greasy or oily • Scales or flakes on the head or in the hair • Crusty yellow flakes on the eyelids or eyelashes What are the There is no cure for seborrheic dermatitis, but there are ways to keep it treatment options? under control. Treatment options for seborrheic dermatitis depend on what part of the body is showing symptoms. Skin Seborrheic dermatitis of the skin can usually be controlled by putting on steroid or antifungal creams to the skin (topical). These medicines help with the redness and itching of your child’s skin. Check with your child’s healthcare provider before giving your child any type of topical medicine. They will help you determine which treatment option would be best. 1 of 2 To Learn More Free Interpreter Services • Dermatology • In the hospital, ask your nurse. -
Understanding Eczema / Atopic Dermatitis
Understanding Atopic Dermatitis An educational health series from National Jewish Health If you would like further information about National Jewish Health, please write to: National Jewish Health 1400 Jackson Street Denver, Colorado 80206 or visit: njhealth.org Understanding Atopic Dermatitis An educational health series from National Jewish Health IN THIS ISSUE About Atopic Dermatitis 2 What Causes Atopic Dermatitis? 3 Do You Have Atopic Dermatitis? 3 Should You Go to an Expert? 4 What Are Your Goals? 4 Avoiding Things that Make Itching and Rash Worse 5 Treatment and Medication Therapy 9 Soak and Seal 9 What Medicines Will Help? 10 Action Plan for Atopic Dermatitis 13 What to Do When Symptoms Are Severe 14 Living with Atopic Dermatitis 15 Remember Your Goals 15 Glossary 16 Note: This information is provided to you as an educational service of National Jewish Health. It is not meant as a substitute for your own doctor. © Copyright 2018, National Jewish Health About Atopic Dermatitis Atopic dermatitis is a common chronic skin disease. It is also called atopic eczema. Atopic is a term used to describe allergic conditions such as asthma and hay fever. Both dermatitis and eczema mean inflammation of the skin. People with atopic dermatitis tend to have dry, itchy and easily irritated skin. They may have times when their skin is clear and other times when they have rash. INFANTS AND SMALL CHILDREN In infants and small children, the rash is often present on face, as well as skin around the knees and elbows. TEENAGERS AND ADULTS In teenagers and adults, the rash is often present in the creases of the wrists, elbows, knees or ankles, and on the face or neck.