Atopic dermatitis, covid 19, and hand dermatitis

Most Recent Atopic Dermatitis Updates

1. Arch Dermatol Res. 2023 Feb 7. doi: 10.1007/s00403-023-02538-0. Online ahead of

print.

The role of insomnia in the vulnerability to depressive and anxiety symptoms in

atopic dermatitis adult patients.

Salfi F(1), Amicucci G(1)(2), Ferrara M(1), Tempesta D(1), De Berardinis

A(1)(3), Chiricozzi A(4)(5), Peris K(4)(5), Fargnoli MC(6)(7), Esposito M(1)(3).

Author information:

(1)Department of Biotechnological and Applied Clinical Sciences, University of

L'Aquila, L'Aquila, Italy.

(2)Department of Psychology, Sapienza University of Rome, Rome, Italy.

(3)UOSD General and Oncologic Dermatology, San Salvatore Hospital, L'Aquila,

Italy.

(4)UOC di DermatologiaDipartimento di Scienze Mediche e Chirurgiche, Fondazione

Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy.

(5)Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università

Cattolica del Sacro Cuore, Rome, Italy.

(6)Department of Biotechnological and Applied Clinical Sciences, University of

L'Aquila, L'Aquila, Italy. mariaconcetta.fargnoli@univaq.it.

(7)UOSD General and Oncologic Dermatology, San Salvatore Hospital, L'Aquila,

Italy. mariaconcetta.fargnoli@univaq.it.

Atopic dermatitis (AD) is a common inflammatory chronic skin disease typically

associated with atopic comorbidities and other non-atopic conditions such as

sleep disturbances, and mood/anxiety disorders. A growing literature proposed a

crucial role of sleep disturbances in the development of mental health problems

in AD. We tested this assumption by mediation model analyses in adult AD

patients.A total of 57 patients (mean age ± std. dev., 34.28 ± 13.07 years; 27

males; range 18-67 years) diagnosed with AD participated in a cross-sectional

study. We evaluated self-perceived severity of AD, insomnia, depression, and

anxiety symptoms using validated questionnaires: the Patient-Oriented Eczema

Measure (POEM), the Insomnia Severity Index (ISI), the Beck Depression

Inventory-second edition (BDI-II), and the Generalized Anxiety Disorder-7 scale

(GAD-7), respectively. Two mediation models were performed, testing the

mediation effect of insomnia symptoms on the relationship between AD severity

and depression (model 1) and anxiety (model 2). AD symptoms, as expressed by

POEM, were positively associated with insomnia, depression, and anxiety

severity. Insomnia fully mediated the effect of AD severity on depression and

anxiety. Specifically, insomnia accounted for 81.64% of the relationship between

atopic eczema severity and depression, and for 81.84% of the effect of AD

severity on anxiety symptoms. The present study proposed a critical role of

insomnia in predisposing adult AD patients to experience depression and anxiety.

Early interventions focused on treating sleep disturbances could indirectly be

beneficial on mental health of patients with AD, counteracting the onset and

exacerbation of anxiety and depression disorders.

DOI: 10.1007/s00403-023-02538-0

PMID: 36749389

2. Dermatitis. 2023 Feb 6. doi: 10.1089/derm.2022.0027. Online ahead of print.

Pooled Analysis of Baricitinib Tolerability in Patients With Atopic Dermatitis

in Relation to Acne, Headache, and Gastrointestinal Events From 8 Clinical

Trials.

Wollenberg A(1)(2), Kircik L(3), Simpson E(4), Brinker D(5), Katoh N(6), Rueda

MJ(5), Issa M(5), Yang F(5), Feely M(5)(7), Alexis A(8).

Author information:

(1)From the *Department of Dermatology and Allergy University Hospital, Ludwig

Maximilian University of Munich, Munich, Germany.

(2)Department of Dermatology, Free University Brussels, University Hospital

Brussels, Brussels, Belgium.

(3)Icahn School of Medicine at Mount Sinai, New York, New York, USA.

(4)Oregon Health & Science University, Portland, Oregon, USA.

(5)Eli Lilly and Company, Indianapolis, Indiana, USA.

(6)Department of Dermatology Kyoto Prefectural University of Medicine, Kyoto,

Japan.

(7)Icahn School of Medicine, Mount Sinai, New York, New York, USA.

(8)Weill Cornell Dermatology, New York, New York, USA.

Background: Tolerability issues including acne, nausea, and headache have been

reported with Janus kinase (JAK) inhibitors for moderate-to-severe atopic

dermatitis (AD). Objectives: To report outcomes of tolerability adverse events

(AEs) for baricitinib, a JAK1/JAK2 inhibitor, in patients with

moderate-to-severe AD. Methods: Acne, headache, and gastrointestinal AEs are

reported from placebo-controlled and long-term extensions of pooled data in the

baricitinib AD clinical trial program. Proportions of patients with AEs,

incidence rates (IRs)/100 patient-years at risk, and median time to

onset/duration of AEs were calculated. Results: In 2531 patients treated with

baricitinib, most AEs were mild to moderate in severity. Headache was the most

common AE of tolerability (median of 14-26 days after first dose of baricitinib,

lasting ≤3 days). IRs of acne were <5 in any group lasting up to a median of 90

days with no severe AEs. Diarrhea was the most common gastrointestinal AE,

lasting a median of ≤7 days. There were few study drug interruptions (n = 6) and

permanent discontinuations (n = 5) for tolerability AEs. Conclusions: For the

AEs of tolerability analyzed, baricitinib appears to be well tolerated. Overall,

the frequency of these AEs in patients being treated for moderate-to-severe AD

was low with few leading to study drug interruption or permanent

discontinuation. Clinical Trial Registration number: NCT02576938; NCT03334396;

NCT03334422; NCT03428100; NCT03435081; NCT03733301; NCT03334435; NCT03559270

Capsule summary In 2531 baricitinib-exposed patients with moderate-to-severe

atopic dermatitis, headache was the most common adverse event (AE) of

tolerability. Across all AEs, the majority were mild to moderate in severity.

There were few study drug interruptions (n = 6 in all patients who received

baricitinib) or permanent study drug discontinuations (n = 5) due to AEs of

tolerability, and baricitinib was generally well tolerated.

DOI: 10.1089/derm.2022.0027

PMID: 36749121

3. Rheumatology (Oxford). 2023 Feb 7:kead067. doi: 10.1093/rheumatology/kead067.

Online ahead of print.

Is Satoyoshi syndrome an autoimmune disease? A systematic review.

Viana Abreu Montanaro V(1), Solís-García Del Pozo J(2), Falcão Hora T(3), León

BH(4), de Cabo C(5), Solera J(6).

Author information:

(1)SARAH Network of Rehabilitation Hospitals, Brasilia, Brasil. Programa de

PósGraduação em Neurologia, Universidade Federal Fluminense, Niterói Brazil.

Radboud University, Nijmegen, The Netherlands.

(2)Department of Internal Medicine, Unit of Infectious Diseases. Complejo

Hospitalario Universitario de Albacete, Albacete, Spain.

(3)SARAH Network of Rehabilitation Hospitals, Brasilia, Brasil.

(4)Department of Pediatrics and Rheumatology, Universidad San Francisco de

Quito, Quito, Ecuador.

(5)Research Department, Neuropsychopharmacology Unit, Complejo Hospitalario

Universitario de Albacete, Albacete, Spain.

(6)Department of Internal Medicine, Complejo Hospitalario Universitario de

Albacete, Albacete, Spain. Department of Medical Sciences, Faculty of Medicine,

Universidad de Castilla-La Mancha, Albacete, Spain.

OBJECTIVES: Satoyoshi syndrome (SS) is a rare multisystem disease of presumed

autoimmunea aetiology. We carried out a systematic review to evaluate the

available evidence to support that autoimmune hypothesis.

METHODS: We searched for SS cases in PubMed, the Web of Knowledge and Scopus up

to January 2022, using keywords "Satoyoshi syndrome" or "Komuragaeri disease".

Data on symptoms, associated autoimmune diseases, presence of autoantibodies and

response to treatment were collected.

RESULTS: 77 patients from 57 articles published between 1967 and 2021 were

included. 59 patients were women. The mean age at diagnosis was 21.2 years. All

cases had painful muscular spasms and alopecia. Frequent manifestations

included: diarrhoea, malabsorption, growth retardation, amenorrhea and bone

deformity. SS was associated with other autoimmune diseases: myasthenia gravis,

autoimmune thyroiditis, idiopathic thrombocytopenic purpura, atopic dermatitis,

bronchial and lupus erythematosus. Autoantibody determinations were performed in

39 patients, of which 27 had positive results. The most frequently detected

autoantibodies were antinuclear antibodies. Other less frequently found

auto-antibodies were: anti-acetylcholine receptor antibodies, anti-DNA

antibodies, antithyroid antibodies, anti-GAD and anti-gliadin antibodies.

Pharmacological treatment was reported in 50 patients. Most of them improved

with corticosteroids, immunosuppressants and immunoglobulins, or a combination

of these medications.

CONCLUSION: SS is associated with other autoimmune diseases and a variety of

autoantibodies. Improvement after corticosteroid or other immunosuppressant

treatment was observed in 90% of cases. These data support an autoimmune

aetiology for SS. More studies including systematic determination of

autoantibodies in all patients with SS will help us advance in our understanding

of this disease.

email: journals.permissions@oup.com.

DOI: 10.1093/rheumatology/kead067

PMID: 36749015

4. Clin Cosmet Investig Dermatol. 2023 Jan 31;16:301-307. doi:

10.2147/CCID.S401815. eCollection 2023.

Increased Expression of Toll-Like Receptor (TLR) 2 and TLR6 on Peripheral Blood

Monocytes by Induction of Staphylococcal Enterotoxin B During Exacerbation of

Atopic Dermatitis Patients.

Salim F(1)(2), Gunawan H(3), Suwarsa O(3), Sutedja E(3).

Author information:

(1)Doctoral Study Program, Faculty of Medicine, Universitas Padjadjaran,

Bandung, West Java, Indonesia.

(2)Department of Dermatology and Venereology, Faculty of Medicine, Universitas

Syiah Kuala, Banda Aceh, Indonesia.

(3)Department of Dermatology and Venereology, Faculty of Medicine, Universitas

Padjadjaran-Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.

BACKGROUND: Atopic dermatitis (AD) is a chronic and recurrent inflammatory skin

disease that can be triggered by various precipitating factors, including

colonization by Staphylococcus aureus (S. aureus). The toll-like receptor (TLR),

which belongs to the family of pattern recognition receptors (PRR), can

recognize components of S. aureus, such as staphylococcal enterotoxin B (SEB).

This receptor is known to be expressed on monocytes. However, the understanding

of the role of SEB in the pathogenesis of AD through the TLR pathway, especially

TLR2 and TLR6, is not widely known.

PURPOSE: To investigate the expression of TLR2 and TLR6 on peripheral blood

monocytes induced by SEB during AD exacerbations.

PATIENTS AND METHODS: Twenty AD patients and 20 healthy subjects as a control

group were selected. A 5 mL blood sample from each subject was taken for

monocyte culture, which was induced by SEB for three days, and the outcomes were

assessed by flow cytometry to evaluate TLR2 and TLR6 expression.

RESULTS: The expression of TLR2 on peripheral blood monocytes in AD patients was

increased compared to healthy controls (p = 0.000), but not for the expression

of TLR6 (p = 0.304). In the AD group, TLR2 and TLR6 expression on peripheral

blood monocytes after being induced by SEB was significantly increased compared

to before induction (p = 0.025 and p = 0.023, respectively), but not in the

control group (p = 0.737 and p = 0.100, respectively).

CONCLUSION: There is significantly increased expression of TLR2 and TLR6 on

peripheral blood monocytes induced by SEB during exacerbation in AD patients.

DOI: 10.2147/CCID.S401815

PMCID: PMC9899008

PMID: 36748066

Conflict of interest statement: The authors report no conflicts of interest in

this work.

5. Dtsch Arztebl Int. 2023 Mar 31;(Forthcoming):arztebl.m2023.0011. doi:

10.3238/arztebl.m2023.0011. Online ahead of print.

Atopic Dermatitis in Childhood and Adolescence: Diagnosis and Treatment.

Wollenberg A, Werfel T, Ring J, Ott H, Gieler U, Weidinger S.

BACKGROUND: Atopic dermatitis is a common, chronically recurring inflammatory

skin disease. It gives rise to a high disease burden and is of major importance

in social medicine.

METHODS: This review is based on pertinent publications retrieved by a selective

search in PubMed, including the current German and European guidelines.

RESULTS: Basic therapy with drug-free topical agents markedly improves the

barrier function of the skin. Adults should apply at least 250 g per week.

Patient-specific trigger factors such as allergens, stress, microbial pathogens,

or skin irritants should be eliminated or avoided. In mild and moderately severe

forms, external treatment with topical glucocorticosteroids and topical

calcineurin inhibitors usually suffices; proactive therapy is given to patients

with frequent recurrences or a long course of disease. Systemic

anti-inflammatory treatment with biological agents such as dupilumab and

tralokinumab, Janus kinase inhibitors such as baricitinib, upadacitinib, and

abrocitinib, or conventional immunosuppressant drugs is indicated particularly

in severe cases. The patient should be actively involved in the choice and

planning of treatment; the patient's age and the cutaneous findings should be

taken into account. Interdisciplinary patient education yields a sustained

benefit.

CONCLUSION: A combination of baseline therapy, reactive and proactive

anti-inflammatory therapy, and systemic therapy as needed is the foundation of

successful interdisciplinary treatment for atopic dermatitis.

DOI: 10.3238/arztebl.m2023.0011

PMID: 36747484

6. Life Sci. 2023 Feb 4:121474. doi: 10.1016/j.lfs.2023.121474. Online ahead of

print.

Integrated transcriptomic and metabolomic analyses of DNCB-induced atopic

dermatitis in mice.

Tang Y(1), Li M(2), Su Y(3), Du Y(4), Wu X(2), Chen X(2), Song Y(5), Lai L(6),

Cheng H(7).

Author information:

(1)Department of Dermatology and Venereology, Zhejiang University School of

Medicine Sir Run Run Shaw Hospital, Hangzhou, China; Department of Dermatology,

Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical

College, Hangzhou, China.

(2)Department of Dermatology and Venereology, Zhejiang University School of

Medicine Sir Run Run Shaw Hospital, Hangzhou, China.

(3)Institute of Immunology, Zhejiang University School of Medicine, Hangzhou

310058, China.

(4)Institute of Immunology, Zhejiang University School of Medicine, Hangzhou

310058, China; Liangzhu Laboratory, Zhejiang University Medical Center, 1369

West Wenyi Road, Hangzhou 311121, China.

(5)Department of Dermatology and Venereology, Zhejiang University School of

Medicine Sir Run Run Shaw Hospital, Hangzhou, China. Electronic address:

3315023@zju.edu.cn.

(6)Department of Dermatology and Venereology, Zhejiang University School of

Medicine Sir Run Run Shaw Hospital, Hangzhou, China. Electronic address:

lailihua@zju.edu.cn.

(7)Department of Dermatology and Venereology, Zhejiang University School of

Medicine Sir Run Run Shaw Hospital, Hangzhou, China. Electronic address:

chenghao1@zju.edu.cn.

AIMS: Atopic dermatitis (AD) is a common chronic inflammatory skin disorder that

affects up to 20 % of children and 10 % of adults worldwide; however, the exact

molecular mechanisms remain largely unknown.

MATERIALS AND METHODS: In this study, we used integrated transcriptomic and

metabolomic analyses to study the potential mechanisms of

1-chloro-2,4-dinitrobenzene (DNCB)-induced AD-like skin lesions.

KEY FINDINGS: We found that DNCB induced AD-like skin lesions, including

phenotypical and histomorphological alterations and transcriptional and

metabolic alterations in mice. A total of 3413 differentially expressed

metabolites were detected between DNCB-induced AD-like mice and healthy

controls, which includes metabolites in taurine and hypotaurine metabolism,

phenylalanine metabolism, biosynthesis of unsaturated fatty acids, tryptophan

metabolism, arachidonic acid metabolism, pantothenate and CoA biosynthesis,

pyrimidine metabolism, and glycerophospholipid metabolism pathways. Furthermore,

the differentially expressed genes associated (DEGs) with these metabolic

pathways were analyzed using RNA sequencing (RNA-seq), and we found that the

expression of pyrimidine metabolism-associated genes was significantly

increased. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis

showed that the glycolysis/gluconeogenesis, glucagon signaling pathway and

pentose phosphate pathway-associated metabolic genes were dramatically altered.

SIGNIFICANCE: Our results explain the possible mechanism of AD at the gene and

metabolite levels and provide potential targets for the development of clinical

drugs for AD.

DOI: 10.1016/j.lfs.2023.121474

PMID: 36746357

Conflict of interest statement: Declaration of competing interest All of the

authors declare that there are no conflicts of interest.

7. Am J Physiol Cell Physiol. 2023 Feb 6. doi: 10.1152/ajpcell.00269.2022. Online

ahead of print.

The role of vasoactive peptides in skin homeostasis - focus on adiponectin and

the kallikrein-kinin system.

Souza-Silva IM(1), Steckelings UM(1), Assersen KB(1)(2).

Author information:

(1)Dept. of Cardiovascular and Renal Research, Institute for Molecular Medicine,

University of Southern Denmark, Odense, Denmark.

(2)Dept. of Dermatology, Odense University Hospital, Odense, Denmark.

Vasoactive peptides often serve a multitude of functions aside from their direct

effects on vasodynamics. This article will review the existing literature on two

vasoactive peptides and their involvement in skin homeostasis: adiponectin and -

as main representative of the kallikrein-kinin-system - bradykinin. Adiponectin

is the most abundantly expressed adipokine in the human organism, where it is

mainly localized in fat depots including subcutaneous adipose tissue, from where

adiponectin can exert paracrine effects. The involvement of adiponectin in skin

homeostasis is supported by a number of studies reporting effects of adiponectin

in isolated human keratinocytes, sebocytes, fibroblasts, melanocytes and immune

cells. Regarding skin pathology, the potential involvement of adiponectin in

psoriasis, atopic dermatitis, scleroderma, keloid and melanogenesis is discussed

in this article. The kallikrein-kinin-system is composed of a variety of enzymes

and peptides, most of which have been identified to be expressed in skin. This

also includes expression of bradykinin receptors on most skin cells. Bradykinin

is one of very few hormones that is targeted by a treatment in routine clinical

use in dermatology - in this case for the treatment of hereditary angioedema.

Potential involvement of bradykinin in wound healing, psoriasis and melanoma is

further discussed in this article. This review concludes with a call for

additional preclinical and clinical studies to further explore the therapeutic

potential of adiponectin supplementation (for psoriasis, atopic dermatitis,

wound healing, scleroderma and keloid) or pharmacological interference with the

kallikrein-kinin-system (for wound healing, psoriasis and melanoma).

DOI: 10.1152/ajpcell.00269.2022

PMID: 36745527

8. Australas J Dermatol. 2023 Feb 6. doi: 10.1111/ajd.13986. Online ahead of print.

Long-term dupilumab therapy in Netherton syndrome with severe atopic

manifestations: Case report and review of the literature.

Özkaya E(1), Günay MB(1), Babuna Kobaner G(1), Keskinkaya Z(1)(2), Gökalp MO(1).

Author information:

(1)Department of Dermatology and Venereology, İstanbul Faculty of Medicine,

İstanbul University, İstanbul, Turkey.

(2)Department of Dermatology and Venereology, Faculty of Medicine, Çanakkale

Onsekiz Mart University, Çanakkale, Turkey.

We herein present a unique patient of Netherton syndrome (NS) with ichthyosis

linearis circumflexa (ILC) lesions associated with severe atopic manifestations

since infancy, showing different responses of atopic and ILC lesions to a 2-year

dupilumab therapy. The atopic eczematous lesions and pruritus healed remarkably,

dramatically improving the patient's quality of life, whilst the scalp hair

showed a clinical and light microscopic improvement. The additional recovery in

axillary/pubic/extremity hair growth, sweating and nail growth in the presented

case was not previously reported in NS patients treated with dupilumab. However,

dupilumab had no therapeutic effect on ILC lesions which were not pruritic and

showed a treatment-independent wax and waned course.

DOI: 10.1111/ajd.13986

PMID: 36745433

9. J Drugs Dermatol. 2023 Feb 1;22(2):SF344607s3-SF344607s14.

Supplement Individual Article: The Importance of a Healthy Skin Barrier From the

Cradle to the Grave Using Ceramide-Containing Cleansers and Moisturizers: A

Review and Consensus.

Schachner L, Alexis A, Andriessen A, Baldwin H, Cork M, Kirsner R, Woolery-Lloyd

INTRODUCTION: Inflammatory skin disorders compromise skin barrier health. Early

and daily skincare use aims to maintain a life-long healthy skin barrier.

Racial/ethnic and age variations in skin barrier properties, cultural

differences, and clinical presentation of the inflammatory skin disorder

influence the choice of treatment and skin care. Ceramide-containing skin care

may play a role in restoring and maintaining a healthy skin barrier.

METHODS: A panel of 6 dermatologists met to develop consensus statements based

on their 8 previous publications on promoting skin barrier health throughout

life using ceramide-containing skin care. The publications covered skin barrier

integrity in the newborn and infant, and the role of the skin barrier in

mitigating atopic dermatitis (AD); racial/ethnic variations in the skin barrier

and implications for skin care; the role of the skin barrier in inflammatory

skin conditions including acne, AD and psoriasis in skin of color (SOC)

populations; skin barrier integrity in patients with rosacea; and xerosis in

patients with diabetes mellitus. The panel synthesized the 8 publications,

selected information from a literature review, and their expert opinions and

experiences to create the statements. The consensus was reached through a

modified Delphi method where the panel met face-to-face and followed up

virtually.

RESULTS: The panel adopted 6 consensus statements highlighting the importance of

skin care in restoring/maintaining a healthy skin barrier in the populations

mentioned above. Skin care suited to this role is gentle, has near-physiologic

pH, is pleasant to use, and contains ceramides. This type of skin care can

promote a healthy skin barrier and attenuate or delay inflammatory skin

conditions.

CONCLUSIONS: Adjunctive daily skin care throughout life promotes a healthy skin

barrier and is beneficial in managing various inflammatory skin disorders in all

populations. However, when choosing optimal treatment and skin care, physicians

should consider variations in age, skin properties, presentation of the

condition, and cultural differences. J Drugs Dermatol. 2023;22:2(Suppl 1):s3-14.

PMID: 36745380

10. J Drugs Dermatol. 2023 Feb 1;22(2):119-131. doi: 10.36849/JDD.7071.

Burden, Control, and Treatment of Moderate to Severe Atopic Dermatitis in 2021:

A United States Patient Survey Study.

Lio P, Mackie D, Bates D, Mulvihill E, Patel M, Kim Y, Shi V.

BACKGROUND: Recent data on unmet needs in the treatment of moderate to severe

atopic dermatitis (AD) in the US are not available.

OBJECTIVE: To describe disease control, quality of life (QoL), and treatment

satisfaction in a United States population with moderate-to-severe AD.

METHODS: Cross-sectional 2021 survey conducted among US patients recruited to an

online survey from Kantar e-profiles, their panel partners, and Global

Perspectives. Adults with self-reported, physician-diagnosed AD completed the

primary survey. Of those reporting moderate to severe AD, a subset, including

patients who “strongly disagreed,” “somewhat disagreed,”

or were “neutral” on the statement “my eczema is adequately

controlled” (“inadequately controlled”) with varying

experience with approved biologic treatment (dupilumab), completed a second,

enriched survey. Outcome measures evaluated included self-reported disease

control and severity and validated measures including Patient-Oriented Scoring

Atopic Dermatitis (PO-SCORAD), Dermatology Life Quality Index (DLQI), Recap of

Atopic Eczema (RECAP), and Treatment Satisfaction Questionnaire for Medication

(TSQM-9).

RESULTS: Of 3,285 patients who participated in the primary survey, 1,935

self-reported moderate-to-severe AD, 979 (51%) of whom reported inadequate

control. A total of 371 completed the enriched survey, leading to an analytic

sample with 87 controlled patients and 284 inadequately controlled patients

(178/284 inadequately controlled patients never received dupilumab, 23

previously received it, and 83 were currently receiving it). Mean RECAP,

PO-SCORAD, and DLQI scores were significantly worse (P<0.01) for inadequately

controlled vs controlled patients: 7.26 vs 13.9; 38.3 vs 26.9; and 9.9 vs 7.0,

respectively. Mean TSQM-9 scores for inadequately controlled vs controlled

patients were significantly worse across all domains—effectiveness,

convenience, and global satisfaction (P<0.01): 45.5 vs 69.5, 62.3 vs 72.5,

48.3 vs 69.3, respectively.

CONCLUSIONS AND RELEVANCE: This study found about half of the patients had

inadequate control of their disease. This may partially be due to underuse of

systemic biologics in eligible patients. There remains an unmet need for

additional education on current and new systemic biologics that could allow

patients to achieve better AD control, improved QoL, and greater overall

treatment satisfaction. J Drugs Dermatol. 2023;22(2):119-131.

doi:10.36849/JDD.7071.

DOI: 10.36849/JDD.7071

PMID: 36745377

Atopic Dermatitis

1. Vet Dermatol. 2020 Aug 13. doi: 10.1111/vde.12873. Online ahead of print.

Measurement of serum Interleukin 34 (IL-34) and correlation with severity and

pruritus scores in client-owned dogs with atopic dermatitis.

Gow DJ(1), Jackson H(2), Forsythe P(2), Nuttall T(1), Gow AG(1), Mellanby RJ(1),

Hume DA(1).

Author information:

(1)R(D)SVS and The Roslin Institute, Hospital for Small Animals, The University

of Edinburgh, Edinburgh, EH25 9RG, Scotland, UK.

(2)The Dermatology Referral Service, 528 Paisley Road West, Glasgow, G51 1RN,

UK.

BACKGROUND: Atopic dermatitis (AD) is a common inflammatory skin disease of

dogs. Interleukin (IL)-34 is a monocyte/macrophage growth factor, produced

mainly by keratinocytes, that has been implicated in several human inflammatory

conditions including human AD.

HYPOTHESIS: Canine serum IL-34 concentrations are increased in dogs with AD and

correlate with clinical lesion and pruritus scores.

ANIMALS: Forty seven client-owned dogs diagnosed with AD and 25 healthy,

unaffected control dogs.

METHODS AND MATERIALS: A commercially available IL-34 ELISA was optimized for

the measurement of IL-34 in canine serum samples. Information regarding

treatment, clinical lesion scores [Canine Atopic Dermatitis Extent and Severity

Index, 4th iteration (CADESI-04)] and pruritus Visual Analog Score (pVAS) were

recorded for each dog at the time of serum collection.

RESULTS: Dogs with AD had significantly increased serum IL-34 concentrations

compared to controls. There was a significant positive correlation between IL-34

concentrations and CADESI-04 and pVAS scores. Concentrations of IL-34 remained

increased in dogs with AD receiving steroids or the JAK1 inhibitor, oclacitinib,

compared to unaffected control dogs.

CONCLUSIONS AND CLINICAL IMPORTANCE: Serum IL-34 concentrations are increased in

dogs with AD and are correlated with clinical severity and pruritus. IL-34 may

be a suitable candidate therapeutic target for canine AD.

Publisher: CONTEXTE: La dermatite atopique (AD) est une dermatose inflammatoire

fréquente chez le chien. L’interleukine (IL)-34 est un facteur de croissance des

monocytes/macrophages principalement produit par les kératinocytes, et est

impliqué dans plusieurs maladies inflammatoires de l’homme dont la dermatite

atopique. HYPOTHÈSES: Les concentrations sériques d’IL-34 canin sont augmentées

chez le chien atopique et corrèlent avec les scores de lésions cliniques et de

prurit.

SUJETS: Quarante sept chiens de propriétaires avec diagnostic d’AD et 25 chiens

sains contrôles. MATÉRIELS ET MÉTHODES: Un test ELISA IL-34 disponible dans le

commerce a été optimisé pour la mesure d’IL-34 des échantillons de serum de

chien. Les données concernant le traitement, les scores clinique [Canine Atopic

Dermatitis Extent and Severity Index, 4th iteration (CADESI-04)] et de prurit

pVAS (pruritus Visual Analog Score) ont été enregistrés pour chaque chien au

moment du prélèvement de serum. RÉSULTATS: Les chiens avec AD avaient des

concentrations sériques d’IL-34 significativement plus élevées comparé aux

contrôles. Il y avait une corrélation positive significative entre les

concentrations d’IL-34 et les scores de CADESI-04 et pVAS. Les concentrations

d’IL-34 restaient élevées chez les chiens atopiques recevant des corticoïdes ou

l’inhibiteur de JAK1, l’oclacitinib, comparé aux chiens non atteints.

CONCLUSIONS ET IMPORTANCE CLINIQUE: Les concentrations sériques d’IL-34 sont

augmentées chez les chiens atopiques et sont corrélés avec la sévérité du prurit

et la clinique. L’IL-34 pourrait être une cible thérapeutique adaptée pour l’AD

canine.

Publisher: INTRODUCCIÓN: la dermatitis atópica (AD) es una enfermedad cutánea

inflamatoria común en los perros. La interlequina (IL)-34 es un factor de

crecimiento de monocitos/macrófagos, producido principalmente por

queratinocitos, que se ha implicado en varias afecciones inflamatorias humanas,

incluida la AD humana. HIPÓTESIS: las concentraciones de IL-34 en suero canino

están aumentadas en perros con AD y se correlacionan con las lesiones clínicas y

los valores de prurito. ANIMALES: cuarenta y siete perros propiedad de clientes

diagnosticados con AD y 25 perros de control sanos y no afectados. MÉTODOS Y

MATERIALES: se optimizó un ELISA IL-34 disponible comercialmente para la

medición de IL-34 en muestras de suero canino. La información sobre el

tratamiento, los valores de lesiones clínicas (Índice de extensión y severidad

de la dermatitis atópica canina, 4ta reevaluación (CADESI-04)) y el valor visual

análogo del prurito (pVAS) se registraron para cada perro en el momento de la

recolección de suero. RESULTADOS: los perros con AD presentaron un incremento

significativo en las concentraciones séricas de IL-34 en comparación con los

controles. Hubo una correlación positiva significativa entre las concentraciones

de IL-34 y los valores de CADESI-04 y pVAS. Las concentraciones de IL-34

permanecieron aumentadas en perros con AD que recibieron esteroides o el

inhibidor de JAK1, oclacitinib, en comparación con los perros de control no

afectados. CONCLUSIONES E IMPORTANCIA CLÍNICA: las concentraciones séricas de

IL-34 aumentan en perros con AD y se correlacionan con la gravedad clínica y el

prurito. IL-34 puede ser un candidato adecuado a objetivo terapéutico para la AD

canina.

Publisher: HINTERGRUND: Die atopische Dermatitis (AD) ist eine häufige

entzündliche Hauterkrankung bei Hunden. Interleukin (IL)-34 ist ein

Monozyten/Makrophagen Wachstumsfaktor, der hauptsächlich von Keratinozyten

produziert wird und bei mehreren entzündlichen Erkrankungen des Menschen wie

auch der humanen AD eine Rolle spielt.

HYPOTHESE: Die caninen IL-34 Serumkonzentrationen sind bei Hunden mit AD erhöht

und korrelieren mit klinischen Veränderungen und den Pruritus Werten.

TIERE: Siebenundvierzig Hunde in Privatbesitz, die mit AD diagnostiziert worden

waren sowie 25 gesunde, nicht betroffene Kontrollhunde nahmen an der Studie

teil.

METHODEN UND MATERIALIEN: Ein kommerziell erhältlicher IL-34 ELISA wurde für die

IL-34 Messung in caninen Serumproben optimiert. Es wurden die Informationen in

Bezug auf die Behandlung, die klinischen Veränderungswerte [Canine Atopic

Dermatitis Extent and Severity Index, 4te Ausgabe (CADESI-04)] und die Pruritus

Visual Analog Score (pVAS) für jeden Hund zum Zeitpunkt der Serumgewinnung

festgehalten.

ERGEBNISSE: Hunde mit AD zeigten im Vergleich zu den Kontrollen signifikant

erhöhte IL-34 Konzentrationen. Es bestand eine signifikant positive Korrelation

zwischen den IL-34 Konzentrationen und dem CADESI-04 und den pVAS Werten. Die

Konzentrationen von IL-34 blieben bei Hunden mit AD während der Verabreichung

von Steroiden oder dem JAK1 Inhibitor, Oclacitinib, im Vergleich zu nicht

betroffenen Kontrollhunden erhöht.

SCHLUSSFOLGERUNGEN UND KLINISCHE BEDEUTUNG: Die Serum IL-34 Konzentrationen sind

bei Hunden mit AD erhöht und mit dem klinischen Schweregrad und dem Juckreiz

korreliert. IL-34 könnte ein passender Kandidat als therapeutisches Ziel für die

AD des Hundes sein.

Publisher: 背景: 异位性皮炎 (AD) 是犬常见的炎性皮肤病。白细胞介素

(IL)-34是一种单核/巨噬细胞生长因子，主要由角质细胞产生，角质细胞也参与包括人AD在内的多种人类炎症。假设:

AD患犬的血清IL-34浓度升高，并且与临床病变和瘙痒评分相关。动物: 诊断为AD的47只私家犬和25只健康、无症状的对照犬。方法和材料:

对测定犬血清IL-34的市售IL-34ELISA进行优化。采集血清时，记录每只犬的治疗信息、临床病变评分 [犬异位性皮炎程度和严重性指数，第4版

(CADESI-04)] 和瘙痒评分 (pVAS)。结果: 与对照组相比，

AD患犬的血清IL-34浓度显著升高。IL-34浓度与CADESI-04、pVAS评分呈显著正相关。与无症状对照犬相比，接受类固醇或JAK1抑制剂-奥拉替尼的AD患犬，其IL-34浓度保持升高。

结论和临床重要性: AD患犬血清IL-34浓度升高，并且与临床严重性和瘙痒相关。IL-34可能是犬AD治疗的合适备选靶点。.

Publisher: 背景:

アトピー性皮膚炎（AD）は、犬の一般的な炎症性皮膚疾患である。インターロイキン（IL）-34は、主にケラチノサイトによって産生される単球/マクロファージ増殖因子であり、人ADを含むいくつかの人の炎症疾患に関与しているとされている。

仮説: イヌの血清IL-34濃度は、AD犬で増加し、臨床病変および掻痒スコアと相関する。被験動物:

ADと診断されたクライアント所有犬47頭および健常で弛緩していない対照犬25頭。材料と方法: 商業的に利用可能なIL-34

ELISAが、犬血清サンプル中のIL-34の測定用に最適化された。治療に関する情報、臨床病変スコア[犬のアトピー性皮膚炎の程度と重症度指数（CADESI-04）]および掻痒性視覚アナログスコア（pVAS）は、血清採取時に各犬について記録された。

結果: AD犬は、対照群と比較して血清IL-34濃度が大幅に増加した。 IL-34濃度とCADESI-04およびpVASスコアの間に有意な正の相関があった。

IL-34の濃度は、罹患していない対照犬と比較して、ステロイドまたはJAK1阻害剤であるオクラシチニブを投与されているAD犬で増加したままであった。

結論と臨床的重要性: AD犬では血清IL-34濃度が増加し、臨床的重症度と掻痒と相関している。 IL-34は犬ADの適切な候補治療標的であり得る。.

Publisher: CONTEXTO: A dermatite atópica (DA) é uma dermatopatia inflamatória

comum de cães. A interleucina (IL) -34 é um fator de crescimento de monócitos /

macrófagos, produzido principalmente por queratinócitos, que tem sido implicado

em várias condições inflamatórias humanas, incluindo a DA. HIPÓTESE: As

concentrações séricas de IL-34 canina aumentam em cães com DA e se correlacionam

com os escores clínicos de lesões e prurido.

ANIMAIS: Quarenta e sete cães diagnosticados com DA pertencentes a clientes e 25

cães saudáveis e não afetados. MÉTODOS E MATERIAIS: Um kit de ELISA para IL-34

disponível comercialmente foi otimizado para a mensuração de IL-34 em amostras

de soro canino. Informações sobre o tratamento, escores de lesões [Índice de

severidade e extensão da dermatite atópica canina, 4ª iteração (CADESI-04)] e a

escala analógica visual de prurido (pVAS) foram registrados para cada cão no

momento da coleta de soro.

RESULTADOS: Cães com DA apresentaram aumento significativo das concentrações

séricas de IL-34 em comparação aos controles. Houve uma correlação positiva

significativa entre as concentrações de IL-34 e os escores CADESI-04 e pVAS. As

concentrações de IL-34 permaneceram aumentadas em cães com DA recebendo

esteroides ou o inibidor de JAK1, oclacitinib, em comparação com cães controle

não afetados. CONCLUSÕES E IMPORTÂNCIA CLÍNICA: As concentrações séricas de

IL-34 estão aumentadas em cães com DA e estão correlacionadas com a gravidade

clínica e o prurido. A IL-34 pode ser uma candidata adequada a alvo terapêutico

para a DA canina.

DOI: 10.1111/vde.12873

PMID: 32794277

2. Allergy. 2020 Aug 13. doi: 10.1111/all.14557. Online ahead of print.

Predicting persistence of atopic dermatitis in children using clinical

attributes and serum proteins.

Lauffer F(1), Baghin V(1), Standl M(2), Stark SP(3), Jargosch M(1), Wehrle

J(4)(5)(6), Thomas J(3), Schmidt-Weber C(3)(7), Biedermann T(1), Eyerich S(3),

Eyerich K(1)(8), Garzorz-Stark N(1)(8).

Author information:

(1)Technical University of Munich, Department of Dermatology and Allergy,

Munich, Germany.

(2)Institute of Epidemiology, Helmholtz Zentrum München - German Research Center

for Environmental Health, Neuherberg, Germany.

(3)Center of Allergy and Environment (ZAUM), Technical University of Munich and

Helmholtz Zentrum Munich, Munich and Neuherberg, Germany.

(4)Department of Medicine I, Medical Center - University of Freiburg, Freiburg,

Germany.

(5)German Cancer Consortium (DKTK), Freiburg, Germany.

(6)German Cancer Research Center (DKFZ), Heidelberg, Germany.

(7)Member of the German Center of Lung Research (DZL), Germany.

(8)Division of Dermatology and Venereology, Department of Medicine Solna, and

Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden.

BACKGROUND: Atopic dermatitis (AD) is the most common inflammatory skin disease

in children, with 30% of all those diagnosed developing chronic or relapsing

disease by adolescence. Such disease persistence cannot yet be predicted. The

aim of the present study was to predict the natural course of AD using clinical

parameters and serum proteins.

METHODS: Sera of 144 children with AD (age 0-3 years) were analyzed for IgE and

33 cytokines, chemokines, and growth factors. Patient disease course until the

age of 7 years was assessed retrospectively. Unsupervised k-means clustering was

performed to define disease endotypes. Identified factors associated with AD

persistence at the age of 7 years were validated in children with AD in an

independent cohort (LISA Munich; n=168). Logistic regression and XGBoosting

methods followed by cross-validation were applied to predict individual disease

outcomes.

RESULTS: Three distinct endotypes were found in infancy, characterized by a

unique inflammatory signature. Factors associated with disease persistence were

disease score (SCORAD), involvement of the limbs, flexural lesion distribution

at the age of 3 years, allergic comorbidities and disease exacerbation by the

trigger factors stress, pollen exposure, and change in weather. Persistence was

predicted with a sensitivity of 81.8% and a specificity of 82.4%. Factors with a

high impact on the prediction of persistence were SCORAD at the age of 3 years,

trigger factors, and low VEGF serum levels.

CONCLUSIONS: AD in infancy comprises three immunological endotypes. Disease

persistence can be predicted using serum cytokines and clinical variables.

DOI: 10.1111/all.14557

PMID: 32794228

3. Am J Ophthalmol Case Rep. 2020 Aug 5;19:100848. doi: 10.1016/j.ajoc.2020.100848.

eCollection 2020 Sep.

Corneal ulceration associated with dupilumab use in a patient with atopic

dermatitis.

Li G(1), Berkenstock M(1), Soiberman U(1).

Author information:

(1)The Wilmer Eye Institute, The Johns Hopkins University School of Medicine,

600 North Wolfe St, Baltimore, MD, 21237, USA.

PURPOSE: To describe a case of corneal ulceration associated with dupilumab use

for atopic dermatitis.

OBSERVATIONS: A patient developed an inflammatory corneal ulcer 3 weeks after

starting bi-weekly intravenous dupilumab therapy. Symptoms resolved with topical

prednisolone and discontinuation of the systemic therapy with dupilumab.

CONCLUSION AND IMPORTANCE: Dupilumab is known to cause ocular surface

inflammation, but we report a novel association between dupilumab use and

potentially sight-threatening corneal ulceration.

DOI: 10.1016/j.ajoc.2020.100848

PMCID: PMC7415768

PMID: 32793843

Conflict of interest statement: No conflicting relationship exists for any

author.

4. Postepy Dermatol Alergol. 2020 Jun;37(3):390-395. doi: 10.5114/ada.2020.96112.

Epub 2020 Jul 16.

Evaluation of contact sensitivity to food additives in children with atopic

dermatitis.

Anıl H(1), Harmancı K(1).

Author information:

(1)Department of Paediatric Allergy and Immunology, Faculty of Medicine,

Osmangazi University, Eskisehir, Turkey.

INTRODUCTION: Atopic dermatitis (AD) is a chronic inflammatory disease caused by

the complex interaction of genetic, immune and environmental factors such as

food and airborne allergens. The atopy patch test (APT) is a useful way to

determine delayed-type hypersensitivity reactions to food and aeroallergens.

Many studies have also suggested that food additives are associated with

dermatologic adverse reactions and the aggravation of pre-existing atopic

dermatitis symptoms.

AIM: To elucidate the contact sensitivity to food additives in children

suffering from AD by using standardized atopy patch testing.

MATERIAL AND METHODS: A total of 45 children with AD and 20 healthy children

have been enrolled. All the children have regularly consumed food containing

additives, and were subjected to atopy patch tests.

RESULTS: In total, 28 (62%) children with AD and 4 (20%) healthy children have

had positive patch test reactions to ≥ 1 allergens. There has been a significant

difference (p = 0.04) between the groups in terms of the positivity rate in the

patch test and the most common allergen that elicited positive patch test

results in the AD group was azorubine (n = 11, 24.4%, p = 0.014).

CONCLUSIONS: In our study, contact sensitivity was detected more frequently in

AD patients. Food additives may play a role in the development and exacerbation

of AD. Atopy patch testing with food additives can be useful in the treatment

and follow-up of children with AD.

DOI: 10.5114/ada.2020.96112

PMCID: PMC7394164

PMID: 32792881

Conflict of interest statement: The authors declare no conflict of interest.

5. Postepy Dermatol Alergol. 2020 Jun;37(3):319-325. doi: 10.5114/ada.2020.96260.

Epub 2020 Jul 16.

The ambiguous pruritogenic role of interleukin-31 in cutaneous T-cell lymphomas

in comparison to atopic dermatitis: a review.

Olszewska B(1), Sokołowska-Wojdyło M(1), Lakomy J(2), Nowicki RJ(1).

Author information:

(1)Department of Dermatology, Venereology and Allergology, Medical University of

Gdansk, Gdansk, Poland.

(2)Department of Pathology, Medical University of Gdansk, Gdansk, Poland.

Cutaneous T-cell lymphomas (CTCLs) comprise a group of chronic heterogeneous

diseases of unknown pathogenesis, characterized by non-specific skin lesions

such as patches, plaques and tumours. CTCL is accompanied by persistent pruritus

poorly responding to antihistamines and therefore significantly reducing quality

of life in patients with lymphomas. According to research data, interleukin-31

(IL-31) contributes to initiation and maintenance of the inflammatory process of

the skin and pruritus in inflammatory dermatoses such as atopic dermatitis (AD),

which is well established. The studies of a similar role of IL-31 in CTCLs are

less homogenous. Due to contradictory reports concerning IL-31 and CTCL we have

analysed available literature to summarize its role, focusing on CTCL and AD.

DOI: 10.5114/ada.2020.96260

PMCID: PMC7394154

PMID: 32792870

Conflict of interest statement: The authors declare no conflict of interest.

6. Cell Death Dis. 2020 Aug 13;11(8):617. doi: 10.1038/s41419-020-02845-8.

Costello syndrome model mice with a Hras(G12S/+) mutation are susceptible to

develop house dust mite-induced atopic dermatitis.

Katata Y(1)(2), Inoue SI(1), Asao A(3), Kobayashi S(3)(4), Terui H(5),

Inoue-Shibui A(1), Abe T(1), Niihori T(1), Aiba S(5), Ishii N(3), Kure S(2),

Aoki Y(6).

Author information:

(1)Department of Medical Genetics, Tohoku University Graduate School of

Medicine, Sendai, Japan.

(2)Department of Pediatrics, Tohoku University Graduate School of Medicine,

Sendai, Japan.

(3)Department of Microbiology and Immunology, Tohoku University Graduate School

of Medicine, Sendai, Japan.

(4)Department of Organ Anatomy, Tohoku University Graduate School of Medicine,

Sendai, Japan.

(5)Department of Dermatology, Tohoku University Graduate School of Medicine,

Sendai, Japan.

(6)Department of Medical Genetics, Tohoku University Graduate School of

Medicine, Sendai, Japan. aokiy@med.tohoku.ac.jp.

Costello syndrome is an autosomal dominant disorder that is caused by germline

HRAS mutations. Patients with Costello syndrome present craniofacial

abnormalities, cardiac defects, and cancer predisposition, as well as skin

abnormalities, including papillomas, keratosis pilaris, and eczematous

dermatitis. However, the mechanisms underlying the dermatological abnormalities

remain unclear. Here, we demonstrated that knock-in mice expressing an Hras G12S

mutation (HrasG12S/+ mice) are susceptible to develop atopic dermatitis

(AD)-like skin lesions, including eczema, pruritus, elevated serum IgE levels,

acanthosis, and the infiltration of mast cells, basophils, and type-2 innate

lymphoid cells in the dermis, after stimulation with house dust mite allergens

(Dermatophagoides farinae, Dfb). Reduced skin barrier function, increased

proliferation of phosphorylated ERK (p-ERK)-positive epidermal cells, and

increased Th2-type cytokines as well as epithelial cell-derived cytokines,

including IL-33, were observed in the skin tissue of HrasG12S/+ mice compared

with Hras+/+ mice. Cultured HrasG12S/+ keratinocytes exhibited increased IL-33

expression after Dfb stimulation. PD0325901, an MEK inhibitor, ameliorated

AD-like symptoms in HrasG12S/+ mice, showing decreased proliferation of

p-ERK-positive epidermal cells and decreased expression of IL-33. Our findings

indicate that the epidermis of HrasG12S/+ mice stimulated by Dfb strongly

induced IL-33 expression and type-2 innate lymphoid cells, resulting in AD-like

skin lesions. These results suggest that the epidermis of HrasG12S/+ mice are

prone to development of eczematous dermatitis stimulated with house dust mite

allergens.

DOI: 10.1038/s41419-020-02845-8

PMID: 32792500

7. Medicine (Baltimore). 2020 Jul 24;99(30):e21255. doi:

10.1097/MD.0000000000021255.

Atopic dermatitis in Taiwanese children: The laboratory values that correlate

best to the SCORAD index are total IgE and positive Cheddar cheese IgE.

Kuo HC(1), Chu CH, Su YJ, Lee CH.

Author information:

(1)aDepartment of Pediatrics and Kawasaki Disease Center, Kaohsiung Chang Gung

Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung

bClinical Trial Center cDepartment of Internal Medicine dDepartment of

Dermatology, Kaohsiung Chang Gung Memorial Hospital, 83301, Taiwan.

Atopic dermatitis (AD) is a common chronic relapsing inflammatory skin disease

associated with a personal or family history of atopic diseases. Determining the

objective severity scoring of AD index (SCORAD) and total immunoglobulin E (IgE)

to help to stage the severity (lesions extent and intensity of the lesions and

then the itch and sleep disturbance they may cause) of AD in children.In this

study, we adopted the SCORAD index, which consists of severity, area, and sleep

disturbance, to evaluate the AD status of children up to 18 years old. We

examined the blood levels of total serum IgE, white blood cell

count/differential count (WBC/DC), eosinophil counts (EC), eosinophil cationic

protein (ECP) and specific IgE.A total of 208 children with AD were enrolled in

this study. Serum IgE values and a number of specific IgE that are positive

significantly different SCORAD index through simple linear regression; however,

after multiple linear regression, only IgE values (95% CI: 0.001-0.004,

P < .001), total WBC count (95% CI: 0.112-1.736, P = .026), EC (95% CI:

0.045-6.706, P = .047), and specific IgE to Cheddar cheese (95% CI:

1.814-16.731, P = .015) remain different. After applying the Phi coefficient, we

found that specific IgE to tuna (r = 0.632), codfish (r = 0.613), and clam

(r = 0.613) each had a moderate correlation with specific IgE to Cheddar cheese.

The 6 most common allergens were found to be mite (D. Farinae: 65.9%), mite (D.

Pterony: 64.9%), house dust (47.6%), cockroach mix (37.0%), shrimp (30.8%), and

crab (22.6%). Covariates of SCORAD index, severity, area, and sleep disturbance

differed.In this study, we found that total IgE values, specific IgE values,

WBC, EC, and specific IgE to Cheddar cheese have significant correlations with

SCORAD index in AD of Taiwanese children.

DOI: 10.1097/MD.0000000000021255

PMID: 32791702

8. Environ Anal Health Toxicol. 2020 Sep;35(3):e2020012-0. doi:

10.5620/eaht.2020012. Epub 2020 Jul 16.

Age-period-cohort analysis of asthma, allergic rhinitis, and atopic dermatitis

prevalence in Japan.

Okui T(1).

Author information:

(1)Medical Information Center, Kyusyu University Hospital, Fukuoka city, Japan.

This study aims to analyze the trends in the Japanese prevalence of asthma,

allergic rhinitis, and atopic dermatitis by using age-period-cohort (APC)

analysis. Data regarding the prevalence of diseases from 1999 to 2017 were

collected from Patient Survey in Japan. The data were divided according to age

groups ranging from 0-4 years old up to 65-69 years old in 5-year increments. A

cohort was defined for each age group of each year with a one-year shift, and

cohorts born from 1930-1934 up to 2013-2017 were examined. We used Bayesian APC

analysis to decompose the changes in prevalence into age, period, and cohort

effects. Results show that the period effect for asthma began to increase in

2008, and those of allergic rhinitis and atopic dermatitis began to increase in

1999. The cohort effects for asthma and atopic dermatitis increased rapidly in

cohorts born from approximately 1950 to 1980 and then decreased thereafter.

Furthermore, the cohort effect for allergic rhinitis increased from cohorts born

in approximately the late 1970s for men and in 1990 for women. The time points

with increasing cohort effects for asthma and atopic dermatitis are consistent

with the history of air pollution accompanied by rapid economic growth in Japan.

The onset of the increased cohort effect for allergic rhinitis was also

relatively consistent with the time point at which the mass scattering of pollen

began.

DOI: 10.5620/eaht.2020012

PMID: 32791576

9. J Allergy Clin Immunol Pract. 2020 Aug 10:S2213-2198(20)30810-2. doi:

10.1016/j.jaip.2020.07.051. Online ahead of print.

The use of probiotics and bacteria-derived preparations in topical treatment of

atopic dermatitis - a systematic review.

Ambrożej D(1), Kunkiel K(1), Dumycz K(1), Feleszko W(2).

Author information:

(1)Department of Pediatric Respiratory Diseases and Allergy,The Medical

University of Warsaw, Warsaw, Poland.

(2)Department of Pediatric Respiratory Diseases and Allergy,The Medical

University of Warsaw, Warsaw, Poland. Electronic address:

wojciech.feleszko@wum.edu.pl.

DOI: 10.1016/j.jaip.2020.07.051

PMID: 32791245

10. Brain Behav Immun. 2020 Aug 10:S0889-1591(20)30486-4. doi:

10.1016/j.bbi.2020.08.003. Online ahead of print.

Depressive and anxiety symptomatology among people with asthma or atopic

dermatitis: a population-based investigation using the UK Biobank data.

Hussain S(1), Ronaldson A(2), Arias de la Torre J(3), Sima R(4), Hatch S(2),

Hotopf M(5), Dregan A(6).

Author information:

(1)Department of Psychological Medicine, Institute of Psychiatry, Psychology,

and Neuroscience, King's College London, London, United Kingdom; School of

Psychology, Victoria University of Wellington, Wellington, New Zealand.

(2)Department of Psychological Medicine, Institute of Psychiatry, Psychology,

and Neuroscience, King's College London, London, United Kingdom.

(3)Department of Psychological Medicine, Institute of Psychiatry, Psychology,

and Neuroscience, King's College London, London, United Kingdom; CIBER

Epidemiology and Public Health (CIBERESP), Madrid, Spain.

(4)USAMV, Cluj-Napoca, Romania.

(5)Department of Psychological Medicine, Institute of Psychiatry, Psychology,

and Neuroscience, King's College London, London, United Kingdom; South London

and Maudsley NHS Foundation Trust, London, United Kingdom.

(6)Department of Psychological Medicine, Institute of Psychiatry, Psychology,

and Neuroscience, King's College London, London, United Kingdom. Electronic

address: alexandru.dregan@kcl.ac.uk.

The present study investigated the association of depression and anxiety

symptomatology (DAS) with asthma and atopic dermatitis (AD) diagnosis during

mid-adult years. The study employed data from 502,641 participants in the UK

Biobank. Neutrophils to Lymphocytes Ratios (NLRs) of patients with asthma and AD

were calculated and evaluated in relation to DAS, measured via the Patient

Health Questionnaire-4 (PHQ-4). Age of asthma or AD onset association with DAS

were also estimated. Multivariable regression analyses were implemented among

participants with asthma or AD, compared to those without these disorders. Out

of 58,833 participants with asthma and 13,462 with AD, the prevalence of DAS was

11.7% and 2.7%, respectively. DAS increased among participants with either

asthma or AD, being highest within patients having both (β= 0.41, 95% confidence

interval (95%CI), 0.34,0.49). NLR showed a linear increase with PHQ scores in

asthma patients, (tertile 1, β= 0.30, 95% CI, 0.27,0.34; tertile 2, β= 0.36,

95%CI, 0.32,0.39, and tertile 3, β= 0.43, 95%CI, 0.39,0.46). An inverted

U-shaped association was seen between age of asthma onset and PHQ, with the

40-59 age group (β= 0.54, 95%CI, 0.48,0.59) showing the highest risk followed by

the 60+ (β= 0.43, 95%CI, 0.34,0.51 and 20-39 groups (β= 0.32, 95%CI, 0.27,0.38).

Similar patterns emerged within AD. Asthma and AD were associated with increased

DAS during mid-adult years, being strongest among participants reporting both

disorders. A dose-response relationship between NLR and DAS was observed. Asthma

or AD onset during mid-adult years (40-59) were associated with the highest

increment in DAS.

DOI: 10.1016/j.bbi.2020.08.003

PMID: 32791209

Atopic Dermatitis and Its Associations

1. Dermatol Ther. 2020 May 27:e13687. doi: 10.1111/dth.13687. Online ahead of

print.

Considerations for safety in the use of systemic medications for psoriasis and

atopic dermatitis during the COVID-19 pandemic.

Ricardo JW(1), Lipner SR(1).

Author information:

(1)Department of Dermatology, Weill Cornell Medicine, New York, New York, USA.

Coronavirus disease 2019 (COVID-19) is responsible for at least 2 546 527 cases

and 175 812 deaths as of April 21, 2020. Psoriasis and atopic dermatitis (AD)

are common, chronic, inflammatory skin conditions, with immune dysregulation as

a shared mechanism; therefore, mainstays of treatment include systemic

immunomodulating therapies. It is unknown whether these therapies are associated

with increased COVID-19 susceptibility or worse outcomes in infected patients.

In this review, we discuss overall infection risks of nonbiologic and biologic

systemic medications for psoriasis and AD and provide therapeutic

recommendations. In summary, in patients with active infection, systemic

conventional medications, the Janus kinase inhibitor tofacitinib, and biologics

for psoriasis should be temporarily held until there is more data; in uninfected

patients switching to safer alternatives should be considered. Interleukin

(IL)-17, IL-12/23, and IL-23 inhibitors are associated with low infection risk,

with IL-17 and IL-23 favored over IL-12/23 inhibitors. Pivotal trials and

postmarketing data also suggest that IL-17 and IL-23 blockers are safer than

tumor necrosis factor alpha blockers. Apremilast, acitretin, and dupilumab have

favorable safety data and may be safely initiated and continued in uninfected

patients. Without definitive COVID-19 data, these recommendations may be useful

in guiding treatment of psoriasis and AD patients during the COVID-19 pandemic.

DOI: 10.1111/dth.13687

PMCID: PMC7283778

PMID: 32458536

2. Br J Dermatol. 2020 Apr 29:10.1111/bjd.19161. doi: 10.1111/bjd.19161. Online

ahead of print.

Global reporting of cases of COVID-19 in psoriasis and atopic dermatitis: an

opportunity to inform care during a pandemic.

Mahil SK(1), Yiu ZZN(2), Mason KJ(2), Dand N(3), Coker B(4), Wall D(5)(6),

Fletcher G(6), Bosma A(7), Capon F(3), Iversen L(8), Langan SM(1)(9), Di Meglio

P(3), Musters AH(7), Prieto-Merino D(9), Tsakok T(1), Warren RB(2), Flohr C(1),

Spuls PI(7), Griffiths CEM(2), Barker J(1), Irvine AD(10), Smith CH(1);

Secure-AD and PsoProtect study groups.

Author information:

(1)St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust

and King's College London, London, UK.

(2)Dermatology Centre, Salford Royal NHS Foundation Trust, The University of

Manchester, Manchester Academic Health Science Centre, NIHR Manchester

Biomedical Research Centre, Manchester, UK.

(3)St John's Institute of Dermatology within the, School of Basic & Medical

Biosciences, King's College London, London, UK.

(4)NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust,

London, UK.

(5)Hair Restoration Blackrock, Dublin, Ireland.

(6)National and International Skin Registry Solutions (NISR), Charles Institute

of Dermatology, Dublin, Ireland.

(7)Department of Dermatology, Amsterdam Public Health, Infection and Immunity,

Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

(8)Department of Dermatology, Aarhus University Hospital, Aarhus C, Denmark.

(9)Faculty of Epidemiology, and Population Health, London School of Hygiene and

Tropical Medicine, London, UK.

(10)Clinical Medicine, Trinity College Dublin, Dublin, Ireland.

We wish to bring your attention to the PsoPROTECT (Psoriasis Patient Registry

for Outcomes, Therapy and Epidemiology of Covid‐19 infecTion) and SECURE‐AD

(Surveillance Epidemiology of Coronavirus Under Research Exclusion‐Atopic

Dermatitis) registries; two urgent global initiatives that address an unmet need

for delineating the determinants of COVID‐19 outcomes in the common cutaneous

immune‐mediated inflammatory diseases (IMIDs) psoriasis and atopic dermatitis.

DOI: 10.1111/bjd.19161

PMCID: PMC7267275

PMID: 32348554

3. Cureus. 2020 Apr 2;12(4):e7506. doi: 10.7759/cureus.7506.

Frequent Hand Washing for COVID-19 Prevention Can Cause Hand Dermatitis:

Management Tips.

Beiu C(1), Mihai M(1), Popa L(1), Cima L(2), Popescu MN(3).

Author information:

(1)Oncologic Dermatology, Elias Emergency University Hospital, "Carol Davila"

University of Medicine and Pharmacy, Bucharest, ROU.

(2)Pharmacy, "Carol Davila" University of Medicine and Pharmacy, Bucharest, ROU.

(3)Physical Medicine and Rehabilitation, "Carol Davila" University of Medicine

and Pharmacy, Bucharest, ROU.

Coronavirus disease 2019 (COVID-19) continues to spread globally, outpacing the

capacity and resources of health systems worldwide. A therapeutic vaccine is not

yet on the rise, and preventive measures are the current approach to restraint

the transmission of cases. As the virus is highly contagious via respiratory

route (droplets from infected persons, widely spread by coughing or sneezing)

and via contact with contaminated surfaces, community transmission and spread

can be decreased through the practice of regular and diligent hand hygiene.

Frequent hand washing implies a prolonged exposure to water and other chemical

or physical agents and may induce several pathophysiologic changes, such as

epidermal barrier disruption, impairment of keratinocytes, the subsequent

release of proinflammatory cytokines, activation of the skin immune system, and

delayed-type hypersensitivity reactions. Adverse dermatologic effects, such as

excessive skin dryness or even contact dermatitis (particularly the irritant

subtype and, to a lesser extent, the allergic subtype), can occur, especially in

individuals with a history of atopic dermatitis. These skin conditions are

perfectly manageable, and applying a moisturizer immediately after washing hands

or after using a portable hand sanitizer is the cornerstone in preventing the

development of eczematous changes in the hands. In the current global context,

the potential occurrence of these dermatological adverse events should in no way

cause people to deviate from strict hand hygiene rules.

DOI: 10.7759/cureus.7506

PMCID: PMC7195203

PMID: 32373409

Conflict of interest statement: The authors have declared that no competing

interests exist.

4. Am J Clin Dermatol. 2020 Jun;21(3):307-311. doi: 10.1007/s40257-020-00514-2.

Managing Cutaneous Immune-Mediated Diseases During the COVID-19 Pandemic.

Torres T(1)(2), Puig L(3).

Author information:

(1)Department of Dermatology, Centro Hospitalar Universitário Do Porto, Porto,

Portugal. torres.tiago@outlook.com.

(2)Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto,

Portugal. torres.tiago@outlook.com.

(3)Department of Dermatology, Hospital de La Santa Creu I Sant Pau, Barcelona,

Spain.

Coronavirus disease 2019 (COVID-19) is a clinical syndrome caused by a novel

coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

COVID-19 has spread rapidly worldwide and has been shown to have a wide spectrum

of severity. COVID-19 has become a public health emergency of relevant

international concern, and it was declared a pandemic by the World Health

Organization on 11 March, 2020. SARS-CoV-2 infection in severe cases involves

the host response as an important contributor to the disease process and tissue

damage, mainly due to dysregulated and excessive innate immune responses. The

primary immune response leads to viral clearance in the majority of cases.

However, in a subgroup of patients, the secondary immune response may be

exaggerated, leading to inflammatory-induced lung injury and other complications

including pneumonitis, acute respiratory distress syndrome, respiratory failure,

shock, organ failure, and potentially death. Several cutaneous immune-mediated

diseases, including psoriasis, atopic dermatitis, and hidradenitis suppurativa,

are therapeutically managed with biologic and non-biologic immunosuppressive and

immunomodulatory drugs. The outbreak of COVID-19 affects the management of these

chronic conditions, not only for those who are already receiving treatment but

also for those who are about to start a new treatment to control their disease.

In this article, the management of cutaneous immune-mediated diseases during the

COVID-19 pandemic is discussed.

DOI: 10.1007/s40257-020-00514-2

PMCID: PMC7147535

PMID: 32277351 [Indexed for MEDLINE]

Conflict of interest statement: Tiago Torres has received consultancy and/or

speaker’s honoraria from and/or participated in clinical trials sponsored by

AbbVie, Amgen, Arena Pharmaceuticals, Boehringer Ingelheim, Bristol Myers

Squibb, Celgene, Janssen, Biocad, LEO Pharma, Eli Lilly, MSD, Novartis, Pfizer,

Samsung-Bioepis, Sanofi-Genzyme, and Sandoz. Luis Puig has received consultancy

and/or speaker’s honoraria from and/or participated in clinical trials sponsored

by AbbVie, Almirall, Amgen, Baxalta, Biogen, Boehringer Ingelheim, Celgene,

Gebro, Janssen, LEO Pharma, Eli Lilly and Company, Merck-Serono, MSD, Mylan,

Novartis, Pfizer, Regeneron, Roche, Sandoz, Samsung-Bioepis, Sanofi, and UCB.

5. J Allergy Clin Immunol Pract. 2020 May;8(5):1477-1488.e5. doi:

10.1016/j.jaip.2020.03.012. Epub 2020 Mar 26.

COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic.

Shaker MS(1), Oppenheimer J(2), Grayson M(3), Stukus D(3), Hartog N(4), Hsieh

EWY(5), Rider N(6), Dutmer CM(5), Vander Leek TK(7), Kim H(8), Chan ES(9), Mack

D(10), Ellis AK(11), Lang D(12), Lieberman J(13), Fleischer D(5), Golden

DBK(14), Wallace D(15), Portnoy J(16), Mosnaim G(17), Greenhawt M(18).

Author information:

(1)Dartmouth-Hitchcock Medical Center, Section of Allergy and Immunology,

Lebanon, NH; Dartmouth Geisel School of Medicine, Hanover, NH.

(2)UMDMJ Rutgers University School of Medicine, Newark, NJ.

(3)Nationwide Children's Hospital, The Ohio State University School of Medicine,

Columbus, Ohio.

(4)Spectrum Health Helen DeVos Children's Hospital, Grand Rapids, Mich.

(5)Children's Hospital Colorado, University of Colorado School of Medicine,

Aurora, Colo.

(6)The Texas Children's Hospital, Section of Immunology, Allergy, and

Retrovirology and the Baylor College of Medicine, Houston, Texas.

(7)Pediatric Allergy and Asthma, Department of Pediatrics, University of

Alberta, Edmonton, AB, Canada.

(8)Western University and McMaster University, London, ON, Canada.

(9)BC Children's Hospital, The University of British Columbia, Vancouver, BC,

Canada.

(10)McMaster University, Hamilton, ON, Canada; Halton Pediatric Allergy,

Burlington, ON, Canada.

(11)Division of Allergy and Immunology, Department of Medicine, Queen's

University, Kingston, ON, Canada.

(12)Department of Medicine, Section of Allergy and Immunology, Cleveland Clinic,

Cleveland, Ohio.

(13)Division of Allergy and Immunology, The University of Tennessee, Memphis,

Tenn.

(14)Division of Allergy and Clinical Immunology, John Hopkins University School

of Medicine, Baltimore, Md.

(15)Nova Southeastern University College of Allopathic Medicine, Fort

Lauderdale, Fla.

(16)Children's Mercy, University of Missouri-Kansas City School of Medicine,

Kansas City, Mo.

(17)Division of Pulmonary, Allergy and Critical Care, Department of Medicine,

NorthShore University Health System, Evanston, Ill.

(18)Children's Hospital Colorado, University of Colorado School of Medicine,

Aurora, Colo. Electronic address: Matthew.Greenhawt@childrenscolorado.org.

Comment in

J Allergy Clin Immunol Pract. 2020 May;8(5):1475-1476.

J Allergy Clin Immunol Pract. 2020 Jul - Aug;8(7):2452-2453.

J Paediatr Child Health. 2020 Jun;56(6):995.

In the event of a global infectious pandemic, drastic measures may be needed

that limit or require adjustment of ambulatory allergy services. However, no

rationale for how to prioritize service shut down and patient care exists. A

consensus-based ad-hoc expert panel of allergy/immunology specialists from the

United States and Canada developed a service and patient prioritization

schematic to temporarily triage allergy/immunology services. Recommendations and

feedback were developed iteratively, using an adapted modified Delphi

methodology to achieve consensus. During the ongoing pandemic while social

distancing is being encouraged, most allergy/immunology care could be

postponed/delayed or handled through virtual care. With the exception of many

patients with primary immunodeficiency, patients on venom immunotherapy, and

patients with asthma of a certain severity, there is limited need for

face-to-face visits under such conditions. These suggestions are intended to

help provide a logical approach to quickly adjust service to mitigate risk to

both medical staff and patients. Importantly, individual community circumstances

may be unique and require contextual consideration. The decision to enact any of

these measures rests with the judgment of each clinician and individual health

care system. Pandemics are unanticipated, and enforced social

distancing/quarantining is highly unusual. This expert panel consensus document

offers a prioritization rational to help guide decision making when such

situations arise and an allergist/immunologist is forced to reduce services or

makes the decision on his or her own to do so.

DOI: 10.1016/j.jaip.2020.03.012

PMCID: PMC7195089

PMID: 32224232 [Indexed for MEDLINE]

6. J Eur Acad Dermatol Venereol. 2020 Jun 25:10.1111/jdv.16774. doi:

10.1111/jdv.16774. Online ahead of print.

Cutaneous manifestations of SARS-CoV-2 infection: a clinical update.

Gisondi P(1), PIaserico S(2), Bordin C(1), Alaibac M(2), Girolomoni G(1), Naldi

L(3)(4).

Author information:

(1)Section of Dermatology and Venereology, Department of Medicine, University of

Verona, Verona, Italy.

(2)Section of Dermatology, Department of Medicine, University of Padua, Padua,

Italy.

(3)Division of Dermatology, San Bortolo Hospital, Vicenza, Italy.

(4)Centro Studi GISED, Bergamo, Italy.

On 11 March 2020, the World Health Organization (WHO) has declared the novel

coronavirus disease (COVID-19) a global pandemic, caused by the severe acute

respiratory syndrome coronavirus 2 (SARS-CoV-2 virus). A consistent number of

case reports and clinical series have been already published describing a

complex spectrum of skin manifestations associated with the SARS-CoV-2

infection. We carried out a review of the English-language literature up to 20

May 2020, reporting original cases or case series of the cutaneous

manifestations of SARS-CoV-2 virus infection. The following databases were

consulted: PubMed, Embase, Google Scholar and ResearchGate. The search of papers

was conducted by using the key term 'COVID-19' or 'SARS-CoV-2' or 'coronavirus'

combined with each of the following: 'skin', 'cutaneous', 'dermatologic' or

'dermatology', 'manifestation', 'lesions', or 'rash'. The patterns of

dermatological manifestations associated with SARS-CoV-2 infection could be

classified into four categories: exanthema (varicella-like, papulo-vesicular and

morbilliform rash), vascular (chilblain-like, purpuric/petechial and livedoid

lesions), urticarial and acro-papular eruption. Lastly, other skin

manifestations to be considered are the cutaneous adverse reactions to the drugs

prescribed for the treatment of COVID-19. Whether SARS-CoV-2 infection can

directly cause a worsening of chronic inflammatory diseases such as psoriasis or

atopic dermatitis remains to be determined. Dermatology's outlook in the

COVID-19 pandemic is multidimensional.

DOI: 10.1111/jdv.16774

PMCID: PMC7362144

PMID: 32585074