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Atopic dermatitis, covid 19, and hand dermatitis
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.
© 2020 ESVD and ACVD, throughout article.
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.
This article is protected by copyright. All rights reserved.
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.
© 2020 The Authors.
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.
Copyright: © 2020 Termedia Sp. z o. o.
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.
Copyright: © 2020 Termedia Sp. z o. o.
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:
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.
Copyright © 2020. Published by Elsevier Inc.
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.
© 2020 Wiley Periodicals LLC.
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.
Copyright © 2020, Beiu et al.
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.
Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by
Elsevier Inc. All rights reserved.
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.
© 2020 European Academy of Dermatology and Venereology.
DOI: 10.1111/jdv.16774
PMCID: PMC7362144
PMID: 32585074
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.
© 2020 Wiley Periodicals LLC.
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.
Copyright © 2020, Beiu et al.
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.
Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by
Elsevier Inc. All rights reserved.
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.
© 2020 European Academy of Dermatology and Venereology.
DOI: 10.1111/jdv.16774
PMCID: PMC7362144
PMID: 32585074
COVID-19 and Atopic Dermatitis
1. Br J Dermatol. 2020 Apr 29. 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 A(7), Prieto-Merino D(9), Tsakok T(1), Warren RB(2), Flohr C(1),
Spuls P(7), Griffiths CEM(2), Barker J(1), Irvine AD(10), Smith CH(1);
Secure-AD, PsoPROTECT study groups.
Author information:
(1)St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation
Trust, London, SE1 9RT, UK.
(2)Dermatology Centre, Salford Royal NHS Foundation Trust, The University of
Manchester, Manchester Academic Health Science Centre, NIHR Manchester
Biomedical Research Centre, Manchester, M13 9PT, UK.
(3)Department of Medical and Molecular Genetics, School of Basic & Medical
Biosciences, Faculty of Life Sciences & Medicine, King's College London, London,
UK.
(4)NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust,
London, SE1 9RT, 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,
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)St. James's Hospital, James's Street, 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.
This article is protected by copyright. All rights reserved.
DOI: 10.1111/bjd.19161
PMID: 32348554
2. J Eur Acad Dermatol Venereol. 2020 Mar 29. doi: 10.1111/jdv.16411. Online ahead
of print.
European Task Force on Atopic Dermatitis (ETFAD) statement on severe acute
respiratory syndrome coronavirus 2 (SARS-Cov-2)-infection and atopic dermatitis.
Wollenberg A(1)(2), Flohr C(3), Simon D(4), Cork MJ(5), Thyssen JP(6)(7), Bieber
T(8), de Bruin-Weller MS(9), Weidinger S(10), Deleuran M(11), Taieb A(12), Paul
C(13), Trzeciak M(14), Werfel T(15), Seneschal J(16), Barbarot S(17), Darsow
U(18), Torrelo A(19), Stalder JF(20), Svensson √Ö(21), Hijnen D(22), Gelmetti
C(23), Szalai Z(24), Gieler U(25), De Raeve L(26), Kunz B(27), Spuls P(28), von
Kobyletzki LB(29)(30), Fölster-Holst R(10), Chernyshov PV(31), Cristen-Zaech
S(32), Heratizadeh A(15), Ring J(33)(34), Vestergaard C(11).
Author information:
(1)Department of Dermatology and Allergy, Ludwig-Maximilian University, Munich,
Germany.
(2)Department of Dermatology I, München Klinik Thalkirchner Strasse, Munich,
Germany.
(3)St John's Institute of Dermatology, King's College London and Guy's & St
Thomas' NHS Foundation Trust, London, UK.
(4)Department of Dermatology, Inselspital, Bern University Hospital, University
of Bern, Bern, Switzerland.
(5)Sheffield Dermatology Research. Department of Infection, Immunity and
Cardiovascular Disease, The University of Sheffield, Sheffield, UK.
(6)Department of Dermatology and Allergy, Herlev and Gentofte Hospital,
Hellerup, Denmark.
(7)Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark.
(8)Department of Dermatology and Allergy, Christine Kühne-Center for Allergy
Research and Education, University Hospital of Bonn, Germany.
(9)National Expertise Center of Atopic Dermatitis, Department of Dermatology and
Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
(10)Department of Dermatology and Allergy, University Hospital
Schleswig-Holstein, Kiel, Germany.
(11)Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
(12)University of Bordeaux, Bordeaux, France.
(13)Department of Dermatology, Toulouse University, Toulouse, France.
(14)Department of Dermatology, Venereology and Allergology, Medical University
of Gdansk, Gdansk, Poland.
(15)Department of Dermatology and Allergy, Hannover Medical School, Hannover,
Germany.
(16)Department of Adult and Pediatric Dermatology, CHU Bordeaux, University of
Bordeaux, Bordeaux, France.
(17)Department of Dermatology, CHU, Nantes, France.
(18)Department of Dermatology and Allergy, Technical University of Munich,
Munich, Germany.
(19)Department of Dermatology, Hospital Infantil Niño Jesús, Madrid, Spain.
(20)Department of Dermatology, Nantes Université, CHU Nantes, UMR 1280 PhAN,
INRAE, F-44000, Nantes, France.
(21)Department of Dermatology, Skane University hospital, Malmö, Sweden.
(22)Department of Dermatology, Erasmus MC University Medical Center, Rotterdam,
The Netherlands.
(23)Department of Pathophysiology and Transplantation, University of Milan,
Head, Unit of Pediatric Dermatology, Milan, Italy.
(24)Department of Dermatology of Heim, P√°l National Children's Institute
Budapest, Budapest, Hungary.
(25)Department of Dermatology, University of Gießen and Marburg GmbH, Gießen,
Germany.
(26)Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Free
University of Brussels (VUB), Brussels, Belgium.
(27)Dermatologicum, Hamburg, Germany.
(28)Department of Dermatology, Amsterdam Public Health, Infection and Immunity,
Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
(29)University Healthcare Research Center, Faculty of Medicine, Lund University,
Malmö, Sweden.
(30)Department of Occupational and Environmental Dermatology, Lund University,
Skåne University Hospital, Malmö, Sweden.
(31)Department of Dermatology and Venereology, National Medical University,
Kiev, Ukraine.
(32)Pediatric Dermatology Unit, Departments of Dermatology and Pediatrics,
Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
(33)Department of Dermatology and Allergy Biederstein, School of Medicine,
Technical University of Munich, Munich, Germany.
(34)Christiane-Kühne Center for Allergy Research and Education (CK-Care), Davos,
Switzerland.
Atopic dermatitis (AD) is a complex disease with elevated risk of respiratory
comorbidities.1,2 Severely affected patients are often treated with
immune-modulating systemic drugs.3,4 On March 11th 2020, the World Health
Organization declared the 2019 novel coronavirus severe acute respiratory
syndrome (SARS-Cov-2) epidemic to be a pandemic. The number of cases worldwide
is increasing exponentially and poses a major health threat, especially for
those who are elderly, immuno-compromised, or have comorbidities. This also
applies to AD patients on systemic immune-modulating treatment. In these days of
uncertainty, reallocation of medical resources, curfew, hoarding, and shutdown
of normal social life, patients, caregivers and doctors ask questions regarding
the continuation of systemic immune-modulating treatment of AD patients. The
ETFAD decided to address some of these questions here.
This article is protected by copyright. All rights reserved.
DOI: 10.1111/jdv.16411
PMID: 32223003
3. J Eur Acad Dermatol Venereol. 2020 Apr 24. doi: 10.1111/jdv.16527. Online ahead
of print.
Safety of dupilumab in severe atopic dermatitis and infection of Covid-19: two
case reports.
Ferrucci S(1), Romagnuolo M(1)(2), Angileri L(1)(2), Berti E(1)(2), Tavecchio
S(1)(2).
Author information:
(1)Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,
Via Pace, 9, 20122, Milan, Italy.
(2)Department of Physiopathology and Transplantation, Università degli Studi di
Milano, Milan, Italy.
Dupilumab is a fully human monoclonal antibody against the alfa subunit of
interleukin (IL)-4 receptor that blocks signalling from both IL-4 and IL-13,
which are key type 2 cytokines in the pathophysiology of atopic dermatitis (AD).
It shows good efficacy with a rapid response and good safety with few side
effects. In a paper of Deleuran et al. the authors showed long term safety and
efficacy of dupilumab; they reported viral upper respiratory tract infection,
cough and influenza in about 2% of patients.
This article is protected by copyright. All rights reserved.
DOI: 10.1111/jdv.16527
PMID: 32330323
4. Am J Clin Dermatol. 2020 Apr 10. doi: 10.1007/s40257-020-00514-2. Online ahead
of print.
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 Universit√°rio 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
PMID: 32277351
5. J Eur Acad Dermatol Venereol. 2020 Apr 27. doi: 10.1111/jdv.16552. Online ahead
of print.
No evidence of increased risk for COVID-19 infection in patients treated with
Dupilumab for atopic dermatitis in a high-epidemic area - Bergamo, Lombardy,
Italy.
Carugno A(1), Raponi F(1), Locatelli AG(1), Vezzoli P(1), Gambini DM(1), Di
Mercurio M(1), Robustelli Test E(2), Sena P(1).
Author information:
(1)UOC Dermatologia, ASST Papa Giovanni XXIII Bergamo Hospital, Lombardy,
Bergamo, Italy.
(2)Dermatology Clinic, Department of Medical Sciences and Public Health,
University of Cagliari, Cagliari, Italy.
Atopic dermatitis (AD) is a chronic inflammatory skin disease. Patients with AD
have increased infection risk, including skin infections and systemic
infections. Dupilumab, a fully human monoclonal antibody, blocks the shared
receptor component for interleukin-4 (IL-4) and IL-13. Dupilumab is approved for
inadequately controlled moderate-to-severe AD.1.
This article is protected by copyright. All rights reserved.
DOI: 10.1111/jdv.16552
PMID: 32339362
6. J Eur Acad Dermatol Venereol. 2020 Apr 22. doi: 10.1111/jdv.16515. Online ahead
of print.
Dermatologists and SARS-CoV-2: The impact of the pandemic on daily practice.
Gisondi P(1), Piaserico S(2), Conti A(3), Naldi L(4)(5).
Author information:
(1)Department of Medicine, Section of Dermatology and Venereology, University of
Verona, Verona, Italy.
(2)Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.
(3)Department of Surgical, Medical, Dental and Morphological Sciences related to
Transplant, Oncology and Regenerative Medicine, Dermatology Unit, University of
Modena and Reggio Emilia, Modena, Italy.
(4)Study Centre of the Italian Group for the Epidemiologic Research in
Dermatology (GISED), Bergamo, Italy.
(5)Department of Dermatology, San Bortolo Hospital, Vicenza, Italy.
Since the first case of "pneumonia of unknown aetiology" was diagnosed at the
Wuhan Jinyintan Hospital in China on 30 December 2019, what was recognised
thereafter as "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2) has
spread over the four continents, causing the respiratory manifestations of
Coronavirus disease-19 (COVID- 19) and satisfying the epidemiological criteria
for a label of "pandemic." The ongoing SARS-CoV-2 pandemic is having a huge
impact on dermatological practice including the marked reduction of face-to-face
consultations in favour of teledermatology, the uncertainties concerning the
outcome of COVID-19 infection in patients with common inflammatory disorders
such as psoriasis or atopic dermatitis receiving
immunosuppressive/immunomodulating systemic therapies; the direct involvement of
dermatologists in COVID-19 care for patients assistance and new research needs
to be addressed. It is not known yet, if skin lesions and derangement of the
skin barrier could make it easier for SARS-CoV-2 to transmit via indirect
contact; it remains to be defined if specific mucosal or skin lesions are
associated with SARS-CoV-2 infection, although some unpublished observations
indicate the occurrence of a transient varicelliform exanthema during the early
phase of the infection. SARS-CoV-2 is a new pathogen for humans that is highly
contagious, can spread quickly, and is capable of causing enormous health,
economic and societal impacts in any setting. The consequences may continue long
after the pandemic resolves, and new management modalities for dermatology may
originate from the COVID-19 disaster. Learning from experience may help to cope
with future major societal changes.
This article is protected by copyright. All rights reserved.
DOI: 10.1111/jdv.16515
PMID: 32320091
7. Dermatol Ther. 2020 May 2. doi: 10.1111/dth.13502. Online ahead of print.
Dupilumab and COVID-19: what should we expect?
Patruno C(1), Stingeni L(2), Fabbrocini G(3), Hansel K(2), Napolitano M(4).
Author information:
(1)Department of Health Sciences, University Magna Graecia of Catanzaro,
Catanzaro, Italy.
(2)Dermatology Section, Department of Medicine, University of Perugia, Perugia,
Italy.
(3)Section of Dermatology, Department of Clinical Medicine and Surgery,
University of Naples Federico II, Naples, Italy.
(4)Department of Health Sciences Vincenzo Tiberio, University of Molise,
Campobasso, Italy.
COVID-19 is a pandemic disease caused by SARS-CoV-2 with high morbidity and
mortality. There are very limited data on the interference of immunomodulating
drugs on the risk of infection and on the course of the disease. In particular,
there are no current clinical data about the interference exerted by dupilumab,
a biologic drugs blocking IL-4 and IL-13, used for adult atopic dermatitis (AD).
The pathogenesis of COVID-19 is complex, characterized by an immune response
mainly Th1/Th17. The hyper-activation of these cells may cause the release of
proinflammatory cytokines that may result in lung impairment. IL-4 and IL-13 are
Th2 cytokines, thus being part of a pathway not considered implicated in host
defense mechanism against viral infections. Indeed, viral infections, including
respiratory infections, have not been reported as a significant adverse event in
clinical trials. Furthermore, dupilumab has been proven to be efficacious also
in exacerbations of asthma, and it is known that viral infections can worsen
asthma. Therefore, the current data seem to suggest that treatment with
dupilumab should not be stopped during COVID-19 pandemic. Obviously, a careful
assessment is mandatory for each individual patient and further studies are
necessary to characterize the immunologic responses in COVID-19. This article is
protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
DOI: 10.1111/dth.13502
PMID: 32362061