This email contains the latest news and
developments in dermatology and is sent to
you from North Bristol NHS Trust
Library & Information Service.
Library & Information Service
Latest News Bulletin
- Dermatology Contact your local NBT library for:
All enquiries
Help with Athens
Inter-library loans
Full-text copies of any of the articles below
Literature searches
Information skills training
Current awareness bulletins
Your NBT libraries:
Frenchay
0117 340 6570 frenchay.library@nbt.nhs.uk
Southmead
0117 323 5333 southmead.library@nbt.nhs.uk
Primary Care Library (South Plaza) 0117 984 1675 nbn-tr.southplazalibrary@nhs.net
For more information on accessing electronic journals please go to
http://library.nhs.uk/booksandjournals/journals/default.aspx or contact your NBT Library.
A Mutation-Independent Therapeutic Strategy for Dominant Dystrophic Epidermolysis
Bullosa
12 Nov 2013 12:00 am
A Mutation-Independent Therapeutic Strategy for Dominant Dystrophic Epidermolysis Bullosa
Journal of Investigative Dermatology 133, 2793 (December 2013).doi:10.1038/jid.2013.241
Authors: Clare P Morgan, Danny S I Allen, Sophia Millington-Ward, Gareth E O'Dwyer, Arpad Palfi & G
Jane Farrar
A case of Björnstad syndrome caused by novel compound heterozygous mutations in the
BCS1L gene
14 Nov 2013 10:43 am
Björnstad syndrome (OMIM 262000) is an autosomal recessive condition characterized by sensorineural
deafness and pili torti1. Only 39 cases of Björnstad syndrome have been reported in the English literature13 and only two cases have been reported in Japan. Thus, the syndrome is an extremely rare inherited
disorder. Herein we present a case of Björnstad syndrome in which novel mutations in the BCS1L gene
were identified. A Japanese female aged 2 years and 3 months who had no family history of hair and
auditory symptoms (Fig. 1a) presented with a 2-year history of sparse hair on the head. This article is
protected by copyright. All rights reserved.
A female with axillary red-brown plaques
09 Nov 2013 12:02 am
Granular parakeratosis is a rare skin disease that was first described by Northcutt et al (1991) (1) as
hyperpigmented to bright red papular patches occurring on the axillae. Considering all cases reported,
granular parakeratosis is predominantly seen in white, middle-aged females.(2) The differential diagnosis
includes acanthosis nigricans, Hailey-Hailey disease, fungal infections, reticulate papillomatosis and
seborrhoeic keratosis. This article is protected by copyright. All rights reserved.
A new KRT16 mutation associated with a phenotype of pachyonychia congenita
27 Nov 2013 04:04 am
Pachyonychia congenita is a rare, autosomal dominant genetic disease characterized by painful
palmoplantar keratoderma and hypertrophic nail dystrophy. This disorder is caused by mutations in any one
of five cytoskeletal keratin proteins, K6a, K6b, K6c, K16 and K17. Here, we describe a new p.Leu421Pro
(c.1262T>C) mutation in the highly conserved helix termination motif of K16 in a large Spanish family.
Bioinformatic analyses as well as previous descriptions in the literature of homologous mutations in other
keratin-coding genes show that this mutation is probably causative of the disease.
A non-coding mutation in the 5′ untranslated region of patched homologue 1 predisposes to
basal cell carcinoma
27 Nov 2013 04:04 am
Mutations in the human homolog of the Drosophila patched gene, patched homologue 1 (PTCH-1), are
responsible for most hereditary and sporadic basal cell carcinomas. Here, we present a father and daughter
with a high propensity for the development of basal cell carcinoma who were heterozygous for a non-coding
germline mutation in the 5′ untranslated region (UTR) of PTCH-1 (insertion of a surplus CGG triplet at the
site of a seven times CGG repeat). We analysed the impact of this mutation on PTCH translation using a
luciferase-based reporter vector. Insertion of an eighth CGG in the 5′ UTR repressed protein translation
dramatically when compared to the wild-type sequence. Our results suggest that this non-coding variant in
the 5′ UTR represents a mutation predisposing to basal cell carcinoma.
A phase II randomized vehicle-controlled trial of intradermal allogeneic fibroblasts for
recessive dystrophic epidermolysis bullosa
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Supriya S. Venugopal , Wenfei Yan , John W. Frew , Heather I. Cohn , Lesley M. Rhodes , Kim
Tran , Wei Melbourne , Janis A. Nelson , Marian Sturm , Janice Fogarty , M. Peter Marinkovich , Satomi
Igawa , Akemi Ishida-Yamamoto , Dedee F. Murrell
Background Chronic wounds are a major source of morbidity and mortality in generalized severe recessive
dystrophic epidermolysis bullosa (RDEB-GS). Objective This was a phase II double-blinded randomized
controlled trial of intralesional allogeneic cultured fibroblasts in suspension solution versus suspension
solution alone for wound healing in RDEB-GS. Methods Adult patients with RDEB-GS were screened for
chronic ulcers and reduced collagen VII expression. Up to 6 pairs of symmetric wounds were measured and
biopsied at baseline, then randomized to cultured allogeneic fibroblasts in a crystalloid suspension solution
with 2% albumin or suspension solution alone. Ulcer size, collagen VII protein and messenger RNA
expression, anchoring fibril numbers, morphology, and inflammatory markers were measured at 2 weeks
and at 3, 6, and 12 months. Results All wounds healed significantly more rapidly with fibroblasts and vehicle
injections, with an area decrease of 50% by 12 weeks, compared with noninjected wounds. Collagen VII
expression increased to a similar degree in both study arms in wounds from 3 of 5 patients. Limitations The
number of patients with RDEB-GS who met inclusion criteria was a limitation, as was 1 trial center rather
than multicenter. Conclusions The injection of both allogeneic fibroblasts and suspension solution alone
improved wound healing in chronic nonhealing RDEB-GS wounds independently of collagen VII
regeneration. This may provide feasible therapy for wound healing in patients with RDEB-GS.
Ambidexterity in Dermatological surgery
07 Nov 2013 10:26 am
Ambidexterity is the state of being equally adept in using both left and right limbs. It is one of the most well
known varieties of cross-dominance.1 People that are naturally ambidextrous are uncommon. It is more
common to find people considered ambidextrous who were originally left handed and who learned to be
ambidextrous, either deliberately or during jobs where right-handed habits are often emphasised or
required. Everyday surgical equipment is designed for right handed people, many left hander surgeons
learn to use them right-handedly due lack of left handed models. This article is protected by copyright. All
rights reserved.
American Academy of Dermatology Choosing Wisely List: Helping dermatologists and their
patients make smart decisions about their care and treatment
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Brett M. Coldiron , Roseanne M. Fischoff
American Board of Dermatology Examination Dates
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Answers to CME examination
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Antimicrobial peptides and pro-inflammatory cytokines are differentially regulated across
epidermal layers following bacterial stimuli
27 Nov 2013 04:04 am
The skin is a natural barrier between the body and the environment and is colonised by a large number of
microorganisms. Here, we report a complete analysis of the response of human skin explants to microbial
stimuli. Using this ex vivo model, we analysed at both the gene and protein level the response of epidermal
cells to Staphylococcus epidermidis (S. epidermidis) and Pseudomonas fluorescens (P. fluorescens), which
are present in the cutaneous microbiota. We showed that both bacterial species affect the structure of skin
explants without penetrating the living epidermis. We showed by real-time quantitative polymerase chain
reaction (qPCR) that S. epidermidis and P. fluorescens increased the levels of transcripts that encode
antimicrobial peptides (AMPs), including human β defensin (hBD)2 and hBD3, and the pro-inflammatory
cytokines interleukin (IL)-1α and (IL)-1-β, as well as IL-6. In addition, we analysed the effects of bacterial
stimuli on the expression profiles of genes related to innate immunity and the inflammatory response across
the epidermal layers, using laser capture microdissection (LCM) coupled to qPCR. We showed that AMP
transcripts were principally upregulated in suprabasal keratinocytes. Conversely, the expression of proinflammatory cytokines was upregulated in the lower epidermis. These findings were confirmed by protein
localisation using specific antibodies coupled to optical or electron microscopy. This work underscores the
potential value of further studies that use LCM on human skin explants model to study the roles and effects
of the epidermal microbiota on human skin physiology.
Aplasia cutis congenita in dystrophic epidermolysis bullosa: clinical and mutational study
20 Nov 2013 05:26 am
Background Aplasia cutis congenita (ACC) has been associated with all clinical forms of inherited
epidermolysis bullosa (EB), including dominant and recessive dystrophic EB (DEB). To date, only a few
patients with DEB specifically combined with ACC have been described and genotyped and almost all
cases represent dominant forms of the condition. Objectives The aim of this study was to describe new
mutations of COL7A1 in patients with DEB and ACC and investigate possible genotype/phenotype
correlations. Methods Twenty two patients with DEB and ACC were included among the 123 DEB patients
whose COL7A1 mutations have been identified in the Reference Centre in Nice. Results Seven patients
presented a severe generalized RDEB phenotype (RDEB-sev gen), while the other 15 suffered from milder
phenotypes. We identified 28 mutations in COL7A1, of which nine are novel. Patients with severe
phenotypes have almost mutations leading to premature termination codon (PTC) and/or splice site
mutation or missense mutations. Patients with the milder phenotypes have mostly glycine or arginine
substitutions associated or not with other types of mutations. All amino acid substitutions fell within the
carboxyl portion of the triple helical domain (THD) of collagen VII, close to the THD interruptions.
Conclusions Our findings suggest that ACC is a frequent manifestation of DEB patients irrespective of the
severity of the disease, and is due to leg rubbing in utero. In children with a moderate form of DEB with no
or moderate skin fragility, a glycine substitution near the THD interruption domain of the collagen VII leading
to thermolabile protein could explain this phenomenon. This article is protected by copyright. All rights
reserved.
Applicability of dermoscopy for evaluation of patients’ response to non-ablative therapies for
the treatment of superficial basal cell carcinoma
27 Nov 2013 07:16 am
Background Applicability of dermoscopy in evaluation of outcome and monitoring of superficial basal cell
carcinoma (sBCC) after non-ablative therapies has not been sufficiently assessed. Objective Certain
dermoscopic criteria, namely pigmented structures, ulceration and arborizing vessels have been suggested
to predict presence of residual disease (residual disease-associated dermoscopic criteria-RDADC). We
aimed to assess this hypothesis. Methods Lesions exhibiting RDADC 3 months after treatment were
biopsied and in case of histopathologic confirmation were excised. Lesions characterized by white/red
structureless areas, superficial fine telangiectasias, or lacking any dermoscopic criterion, were monitored for
12 months. Results At the 3-month evaluation, one or more of the RDADC were detected in 25/98 (25.5%)
sBCCs, in which histology confirmed tumor persistence. In 45(61.6%) of the 73 remaining lesions,
dermoscopy showed red/white structureless areas and/or superficial fine telangiectasias. Twenty-eight
lacked any dermoscopic criterion of sBCC. The two latter groups entered follow-up. In total, disease
recurred in 13 (17.8%) of the 73 lesions. Conclusions RDADC accurately predict residual disease. Absence
of dermoscopic criteria of sBCC safely predicts complete histopathologic clearance. Detection of red/white
structureless areas and/or superficial fine telangiectasias warrants close monitoring to recognize early
recurrence. This article is protected by copyright. All rights reserved.
Association of 25-hydroxyvitamin D serum levels and metabolic parameters in psoriatic
patients with and without arthritis
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Jacinto Orgaz-Molina , Cesar Magro-Checa , José Luis Rosales-Alexander , Miguel A. ArrabalPolo , Agustín Buendía-Eisman , Enrique Raya-Alvarez , Salvador Arias-Santiago
Background Psoriasis has been related to a higher prevalence of cardiovascular risk factors. Vitamin-D
deficiency has been associated with metabolic syndrome, cardiovascular disease, and psoriasis. However,
there has been no comparative study on the effects of vitamin-D status between patients with and without
psoriatic arthritis. Objective The objective was to assess the relationship of 25-hydroxyvitamin D [25-(OH)D]
levels with lipid and glucose metabolism parameters in psoriatic patients with and without arthritis. Methods
We studied 122 patients with psoriasis (61 without arthritis and 61 with arthritis) from the psoriasis unit
(dermatology department) and rheumatology department of our hospital, analyzing lipid and glucose
metabolism variables and serum 25-(OH)D concentrations. Measurements were conducted within a 2month period to minimize seasonal bias in 25-(OH)D levels. Results In the psoriatic patients without
arthritis, serum 25-(OH)D levels were inversely correlated with fasting glucose ( r = −0.285; P = .026), total
cholesterol ( r = −0.440; P = .000), low-density lipoprotein ( r = −0.415; P = .001), total cholesterol/highdensity lipoprotein ( r = −0.303; P = .01), and triglyceride ( r = −0.280; P = .029) values. This association
remained statistically significant for glucose, total cholesterol, and low-density lipoprotein after controlling for
confounding factors in multivariate analysis. No association was found between serum 25-(OH)D levels and
any metabolic parameter in the patients with psoriatic arthritis. Limitations This is a cross-sectional study
that supports the hypothesis of an association between vitamin D and metabolic parameters but does not
establish a causal relationship. Conclusions Serum 25-(OH)D was inversely related to lipid and glucose
metabolism parameters in psoriatic patients without arthritis, whereas no such association was observed in
psoriatic patients with arthritis. Interventional studies are warranted to assess the effects of vitamin-D
supplements on the metabolic profile of psoriatic patients without arthritis.
Association of Serum B-Cell Activating Factor Level and Proportion of Memory and
Transitional B Cells with Clinical Response after Rituximab Treatment of Bullous
Pemphigoid Patients
12 Nov 2013 12:00 am
Association of Serum B-Cell Activating Factor Level and Proportion of Memory and Transitional B
Cells with Clinical Response after Rituximab Treatment of Bullous Pemphigoid Patients
Journal of Investigative Dermatology 133, 2786 (December 2013).doi:10.1038/jid.2013.236
Authors: Russell P Hall, Robert D Streilein, Deborah L Hannah, Patrice D McNair, Janet A Fairley, Arash
Ronaghy, Kim D Edhegard & Marc C Levesque
BJD Editor's Choice
12 Nov 2013 12:00 am
BJD Editor's Choice
Journal of Investigative Dermatology 133, 2657 (December 2013).doi:10.1038/jid.2013.407
Bone Morphogenetic Protein Signaling Suppresses Wound-Induced Skin Repair by
Inhibiting Keratinocyte Proliferation and Migration
07 Nov 2013 12:00 am
Bone Morphogenetic Protein Signaling Suppresses Wound-Induced Skin Repair by Inhibiting
Keratinocyte Proliferation and Migration
Journal of Investigative Dermatology advance online publication, November 7
2013.doi:10.1038/jid.2013.419
Authors: Christopher J Lewis, Andrei N Mardaryev, Krzysztof Poterlowicz, Tatyana Y Sharova, Ahmar Aziz,
David T Sharpe, Natalia V Botchkareva & Andrey A Sharov
CME examination
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Calmodulin-like skin protein level increases in the differentiated epidermal layers in atopic
dermatitis
27 Nov 2013 04:04 am
In atopic dermatitis (AD), the skin barrier is disturbed, and the expression of calcium-dependent S100
proteins and the calcium gradient is also altered in the epidermis. The calmodulin-like skin protein (CLSP),
which is expressed in the differentiated epidermis, is believed to modulate the function of calciumdependent proteins involved in barrier formation and is significantly increased in the epidermis of psoriatic
patients. We, therefore, investigated the CLSP level in skin biopsies taken from patients with acute
exacerbated and non-exacerbated AD as well as from healthy control subjects. Immunohistochemical,
Western blot and ELISA analyses showed significant increases (P < 0.03) in CLSP level in the epidermis
from patients with acute exacerbated AD as compared to that from patients with non-exacerbated AD and
from control subjects. Such increased expression of CLSP may help re-establish a functional epidermal
barrier in acute AD.
Catecholamine Stress Alters Neutrophil Trafficking and Impairs Wound Healing by β2Adrenergic Receptor–Mediated Upregulation of IL-6
07 Nov 2013 12:00 am
Catecholamine Stress Alters Neutrophil Trafficking and Impairs Wound Healing by β2-Adrenergic
Receptor–Mediated Upregulation of IL-6
Journal of Investigative Dermatology advance online publication, November 7
2013.doi:10.1038/jid.2013.415
Authors: Min-Ho Kim, Farzam Gorouhi, Sandra Ramirez, Jennifer L Granick, Barbara A Byrne, Athena M
Soulika, Scott I Simon & R Rivkah Isseroff
Cells or signals: which moves to drive skin pattern formation?
27 Nov 2013 04:04 am
During its development, the skin produces an array of evenly spaced hair follicles. How the location of each
follicle is determined to produce this pattern has been the subject of study and speculation for several
decades. A central unresolved issue is the extent to which movement of scattered, precommitted follicle
cells might play a role in this process. Xavier et al. now report the identification of subpopulations of dermal
cells in developing sheep skin which are positive for Delta1 expression, suggesting that these cells may
represent precommitted dermal papilla cells and that dermal Notch pathway signalling plays a role in hair
follicle patterning.
Change of Address
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Characterization of the Human Hair Shaft Cuticle–Specific Keratin-Associated Protein 10
Family
12 Nov 2013 12:00 am
Characterization of the Human Hair Shaft Cuticle–Specific Keratin-Associated Protein 10 Family
Journal of Investigative Dermatology 133, 2780 (December 2013).doi:10.1038/jid.2013.233
Authors: Hiroki Fujikawa, Atsushi Fujimoto, Muhammad Farooq, Masaaki Ito & Yutaka Shimomura
Circulating cell-free DNA levels in Portuguese patients with psoriasis vulgaris according to
severity and therapy
18 Nov 2013 12:28 pm
Background Inflammation has a key role in psoriasis pathogenesis. Circulating cell-free DNA (CFD) is a
marker of tissue cell damage closely associated with inflammation. Objectives We aimed to understand the
relation of CFD levels with psoriasis severity, defined by Psoriasis Area and Severity Index (PASI), with
inflammation and with psoriasis therapy. Methods 46 psoriasis vulgaris patients were evaluated before (T0)
and after 12 weeks (T12) of treatment with narrow-band ultraviolet light B (NB-UVB; n=17)), psoralen plus
UVA (PUVA; n=20) or topical therapy (n=9). We evaluated interleukin-6 (IL-6) and circulating CFD levels.
Results Compared to controls, at T0, patients presented significantly higher levels of circulating CFD. CFD
presented a significant positive correlation with IL-6 and a trend towards a positive correlation with PASI.
Multiple linear regression analysis identified IL-6 as an independent variable associated with CFD
circulating levels. According to PASI, a trend towards higher values of CFD was observed in the severe
psoriasis forms; moderate and severe psoriasis presented also significantly higher CFD values, as
compared to control. NB-UVB and PUVA treatment decreased both, significantly, the levels of CFD.
Conclusion Psoriatic patients, at the active stage of the disease, presented an increased inflammation
associated with raised circulating CFD levels, which seem to be linked to psoriasis severity. Both NB-UVB
and PUVA, anti-inflammatory therapies, were effective in decreasing CFD values. We propose that the
evaluation of circulating CFD may provide a new biomarker to monitor psoriasis, its severity and its
treatment. This article is protected by copyright. All rights reserved.
Clinical Snippets
12 Nov 2013 12:00 am
Clinical Snippets
Journal of Investigative Dermatology 133, 2656 (December 2013).doi:10.1038/jid.2013.406
Coculture system of keratinocytes and dorsal-root-ganglion-derived cells for screening
neurotrophic factors involved in guidance of neuronal axon growth in the skin
23 Nov 2013 07:52 am
The density of peripheral nerve fibers is increased in atopic dermatitis. Moreover, reduction of the fibers in a
mouse model of atopic dermatitis reduces scratching behavior. Thus, regulation of nerve fiber extension
could be an effective strategy to reduce itching in pruritus dermatosis. In the present study, we established
a new co-culture system of keratinocytes and dorsal-root-ganglion-derived cells using an apparatus,
AXIS™, which consists of two different channels connected via a set of microgrooves, through which
signaling molecules and axons, but not living cells, can pass. When we seeded keratinocytes in one
chamber, extension of nerve fibers was observed from dorsal-root ganglion cells seeded in the other
chamber. Addition of anti-BDNF antibody in the keratinocyte-seeded chamber significantly reduced the
extension. Application of Semaphorin 3A also reduced the extension by approximately 50%. We suggest
that this co-culture system may be useful for screening of anti-itching drugs. This article is protected by
copyright. All rights reserved.
Compliance by California tanning facilities with the nation’s first statewide ban on use
before the age of 18 years
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Sungat K. Grewal , Ann F. Haas , Mark J. Pletcher , Jack S. Resneck Jr.
Background Exposure to indoor tanning, especially at younger ages, is associated with increased risk of
skin cancer. Even in states with parental consent requirements, teenagers used tanning facilities at high
rates. In 2011, California became the first state to pass a complete ban on indoor tanning by those younger
than 18 years. Objective We sought to determine whether tanning facilities in California were in compliance
with the new law. Methods In a cross-sectional study, telephone calls were placed in May 2013 to a
statewide random sample of tanning facilities by a study investigator indicating that she was 17 years old.
Results Of 600 advertised indoor tanning facilities, 338 met inclusion criteria. A majority of respondents
(77%, 95% confidence interval 72%-81%) told the underage caller that she could not use their ultraviolet
tanning facility. Most facilities, however, denied any dangers from ultraviolet tanning (61%) and made
unlawful claims of specific health benefits, including vitamin-D production (44%), skin disease treatment
(22%), prevention of future sunburns (17%), and prevention or treatment of depression (8%). Limitations
Tanning facilities may respond differently to a 17-year-old’s request to tan in person versus by telephone.
Conclusion Given strong evidence linking indoor tanning to skin cancer, and the tanning industry’s
documented history of marketing specifically to teenagers, this study suggests that laws banning indoor
tanning younger than 18 years can meaningfully impact access. Additional enforcement, however, may be
required to bring about accurate disclosure of risk and prevent claims of unproven health benefits.
Congenital erosive and vesicular dermatosis with reticulated supple scarring: Unifying
clinical features
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Brook E. Tlougan , Amy S. Paller , Julie V. Schaffer , Joshua O. Podjasek , Jenny A. Mandell ,
Xuan H. Nguyen , Mary K. Spraker , Ronald C. Hansen
Background Congenital erosive and vesicular dermatosis (CEVD) healing with reticulated supple scarring, a
condition usually observed in premature neonates, presents at birth with vesicles and erosions. Lesions
typically heal within a few months, leaving behind scarring with a distinctive supple and reticulated texture.
Objectives We sought to merge existing literature with new cases to further define CEVD. Methods We
analyzed 19 previous reports of CEVD and added 9 additional patients; we identified unifying characteristics
of this cohort. Results In 28 total cases, notable features included: preterm birth (79%), nail abnormalities
(46%), hyperthermia/hypohidrosis (46%), a history of maternal chorioamnionitis (43%), alopecia (43%),
neurodevelopmental and ophthalmologic abnormalities (36% each), tongue atrophy (29%), or a
combination of these. Patients with CEVD may be prone to postnatal herpetic superinfections. Previously
unreported findings included: erosive lichen planus, digital tip gangrene, and hydronephrosis. Limitations
The small patient sampling makes it difficult to define diagnostic criteria. As certain findings are associated
with prematurity, it is unclear to what extent these features result from CEVD, premature birth, or another
intrauterine pathology. Conclusions Although rare, CEVD should be considered in the differential diagnosis
of neonatal vesicles/erosions in the context of a negative infectious workup. This review strengthens the
spectrum of CEVD features, thus facilitating its recognition by clinicians.
Correction
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Crosstalk between Keratinocytes and T Cells in a 3D Microenvironment: A Model to Study
Inflammatory Skin Diseases
07 Nov 2013 12:00 am
Crosstalk between Keratinocytes and T Cells in a 3D Microenvironment: A Model to Study
Inflammatory Skin Diseases
Journal of Investigative Dermatology advance online publication, November 7
2013.doi:10.1038/jid.2013.417
Authors: Ellen H van den Bogaard, Geuranne S Tjabringa, Irma Joosten, Mieke Vonk-Bergers, Esther van
Rijssen, Henk J Tijssen, Mirthe Erkens, Joost Schalkwijk & Hans J.P.M. Koenen
Current status of surgery in dermatology
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): C. William Hanke , Ronald L. Moy , Randall K. Roenigk , Henry H. Roenigk Jr. , James M.
Spencer , Emily P. Tierney , Cynthia L. Bartus , Robert M. Bernstein , Marc D. Brown , Mariano Busso ,
Alastair Carruthers , Jean Carruthers , Omar A. Ibrahimi , Arielle N.B. Kauvar , Kathryn M. Kent , Nils
Krueger , Marina Landau , Aimee L. Leonard , Stephen H. Mandy , Thomas E. Rohrer , Neil S. Sadick ,
Luitgard G. Wiest
An article titled “Current issues in dermatologic office-based surgery” was published in the JAAD in October
1999 (volume 41, issue 4, pp. 624-634). The article was developed by the Joint American Academy of
Dermatology/American Society for Dermatologic Surgery Liaison Committee. A number of subjects were
addressed in the article including surgical training program requirements for dermatology residents
and selected advances in dermatologic surgery that had been pioneered by dermatologists. The
article concluded with sections on credentialing, privileging, and accreditation of office-based surgical
facilities. Much has changed since 1999, including more stringent requirements for surgical training
during dermatology residency, and the establishment of 57 accredited Procedural Dermatology
Fellowship Training Programs. All of these changes have been overseen and approved by the Residency
Review Committee for Dermatology and the Accreditation Committee for Graduate Medical Education. The
fertile academic environment of academic training programs with interaction between established
dermatologic surgeons and fellows, as well as the inquisitive nature of many of our colleagues, has led to
the numerous major advances in dermatologic surgery, which are described herein. Learning objectives
Dermatologists have been responsible for multiple advances and refinements in dermatologic office-based
surgery over many decades. Dermatologists receive extensive training in office-based surgical procedures
during residency, fellowships, and continuing medical education courses. The last update on this subject
appeared in the Journal in 1999. This article will document the multitude of advances that have occurred
since 1999.
Cycling up the epidermis: reconciling 100 years of debate
21 Nov 2013 10:33 am
There is likely general consensus within the skin research community that cell cycle control is critical to
epidermal homeostasis and disease. The current predominant model proposes that keratinocytes switch off
DNA replication and undergo cell cycle and cell growth arrest as they initiate terminal differentiation.
However, this model cannot explain key physiological features of the skin, mainly why squamous
differentiation prevails over proliferation in benign hyperproliferative disorders. In recent years we have
proposed an alternative model that involves mitotic slippage and endoreplication. This new model is
controversial and has encountered resistance within the field. However, looking back at history, the
epidermal cell cycle has been a matter of controversy and debate for around 100 years now. The
accumulated data are confusing and contradictory. Our present model can explain and reconcile both old
and new paradoxical observations. Here we explain and discuss the endoreplicative cell cycle, the evidence
for and against its existence in human epidermis and the important implications for skin homeostasis and
disease. We show that regardless of the strengths or weaknesses of the Endoreplication Model, the existing
evidence in support of the Cell Cycle Arrest Model is very weak. This article is protected by copyright. All
rights reserved.
Dermatologists' blind side The ethical implications of in-house dermatopathology
laboratories
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Jane M. Grant-Kels
Dermoscopy in general dermatology: practical tips for the clinician
22 Nov 2013 02:41 pm
In addition to its well-documented value in improving the diagnosis of skin tumours, dermoscopy is
continually gaining appreciation in the field of general dermatology. Dermoscopy has been shown to
facilitate the clinical recognition of several inflammatory and infectious diseases, as well as their
discrimination from skin tumours. Moreover, recent data indicate that it might also be profitable in assessing
the outcome and adverse effects of various treatments. Application of dermoscopy should follow the
standard procedure of acquiring information from patient history and clinically evaluating the number,
location and morphology of the lesion(s). Four parameters should be assessed when applying dermoscopy
in the realm of inflammatory and infectious diseases: 1) morphologic vascular patterns; 2) arrangement of
vascular structures; 3) colours; and 4) follicular abnormalities, while the presence of other specific features
(clues) should also be evaluated. It must be underlined that dermoscopic findings should be always
interpreted within the overall clinical context of the patient, integrated with information from the history and
the macroscopic examination. With new evidence continuously being gathered, the dermatoscope gradually
acquires a role similar to the stethoscope of general practitioners, becoming an irreplaceable clinical tool for
dermatologists. In this article, we provide a succinct summary of existing data on dermoscopy in general
dermatology. Practical tips are suggested, which can assist clinicians in profitably utilizing and applying the
available knowledge in their everyday practice. This article is protected by copyright. All rights reserved.
Designing Randomized-Controlled Trials to Improve Head-Louse Treatment: Systematic
Review Using a Vignette-Based Method
14 Nov 2013 12:00 am
Designing Randomized-Controlled Trials to Improve Head-Louse Treatment: Systematic Review
Using a Vignette-Based Method
Journal of Investigative Dermatology advance online publication, November 14
2013.doi:10.1038/jid.2013.414
Authors: Giao Do-Pham, Laurence Le Cleach, Bruno Giraudeau, Annabel Maruani, Olivier Chosidow &
Philippe Ravaud
Detection of common mutations in sporadic primary localized cutaneous amyloidosis by
DNA mass spectrometry
14 Nov 2013 10:43 am
Primary localized cutaneous amyloidosis (PLCA [OMIM 105250]) is a relatively common itchy skin disorder
in South America and Southeast Asia.1-2 The precise pathogenesis of PLCA is unclear, but it is considered
to be multifactorial, involving both genetic and environmental factors. Most PLCA cases are sporadic. In
Southeast Asia, familial PLCA (FPLCA) is also prevalent.1 Genome-wide linkage analyses have revealed
that disease susceptibility loci of a significant portion of collected pedigrees are mapped to chromosome
5p13.1-q11.2.3,4 Subsequent investigation has identified missense mutations in the oncostatin M receptor
(OSMR) or interleukin-31 receptor A (IL31RA) genes.4-9 This article is protected by copyright. All rights
reserved.
Diagnosing and Treating Psoriatic Arthritis—an Update
23 Nov 2013 02:14 am
Psoriatic arthritis (PsA) is an inflammatory arthritis of uncertain pathogenesis, affecting approximately 1 in 4
patients with psoriasis. Onset of psoriasis typically precedes development of PsA. Therefore, the
dermatologist is ideally positioned to recognise the early signs and symptoms of PsA for diagnosis and
subsequent treatment. The role of the dermatologist in early diagnosis and treatment is essential for
preventing pain and functional disabilities, as well as joint deterioration that accompanies progressive forms
of PsA. Diagnosis of PsA is a key aspect of the clinical decision process for the dermatologist, as psoriasis
plus PsA requires a different therapeutic approach to that required for psoriasis alone. Furthermore, PsA is
associated with an increased risk of cardiovascular comorbidities that present significant health concerns. In
this review, PsA pathogenesis and comorbidities are discussed. In addition, screening and imaging tools
that aid in the diagnosis of PsA, as well as tools used for efficacy assessment, are reviewed. Available
therapies are presented, with a focus on targeted biologics and emerging treatments. This article is
protected by copyright. All rights reserved.
Diet and Physical Exercise in Psoriasis. A Randomized Trial
14 Nov 2013 10:43 am
Background Increased body mass index and weight gain are risk factors for psoriasis, and the prevalence
of obesity in patients with psoriasis is higher than in the general population. Limited data exist regarding the
role of diet in psoriasis. Here we assessed the impact of a dietary intervention combined with physical
exercise for weight loss on improving psoriasis in overweight or obese patients. Methods This study
included 303 overweight or obese patients with moderate-to-severe chronic plaque psoriasis not achieving
clearance after 4 weeks of continuous systemic treatment. They were randomized to receive a 20-week
quantitative and qualitative dietary plan associated with physical exercise for weight loss, or simple
informative counseling at baseline about the utility of weight loss for clinical control of psoriatic disease. The
main outcome was any reduction of the Psoriasis Area and Severity Index (PASI) from baseline to week 20.
Results Intention-to-treat analysis showed a median PASI reduction of 48% (95% confidence interval, 33.3
to 58.3%) in the dietary intervention arm and 25.5% (95% confidence interval, 18.2 to 33.3%) in the
information-only arm (P=0.02). Among secondary outcomes, PASI50 significantly differed between study
arms (49.7% with dietary intervention vs. 34.2% with information only, P=0.006). The weight-loss target (a
≥5% reduction from baseline) was reached by 29.8% of patients in the dietary intervention arm compared to
14.5% in the information-only arm (P=0.001). Conclusions A 20-week dietetic intervention associated with
increased physical exercise reduced psoriasis severity in systemically treated overweight or obese patients
with active psoriasis. This article is protected by copyright. All rights reserved.
Duration of efficacy increases with the repetition of botulinum toxin A injections in primary
axillary hyperhidrosis: A study in 83 patients
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Marie Lecouflet , Christophe Leux , Marion Fenot , Philippe Célerier , Hervé Maillard
Background Intradermal injections of botulinum toxin are effective but transitory in primary axillary
hyperhidrosis. These injections are repeated when the symptoms recur. The reported duration of efficacy is
variable, from 2 to 24 months, but it is unknown how the duration of efficacy changes when injections are
repeated. Objective In this retrospective study, we aimed to evaluate changes in the duration of efficacy of
botulinum toxin injections (Dysport, Ipsen, Boulogne-Billancourt, France) with the repetition of injections in
patients with axillary hyperhidrosis. Methods From May 2001 to April 2012 inclusive, 83 patients were
treated with a dose of 125 U per underarm. We compared the duration of effect of the first and last toxin
injections. Results The median duration of efficacy for the first injection was 5.5 months, whereas that for
the last injection was 8.5 months. The difference between these 2 durations is statistically significant ( P =
.0002). Limitations Although retrospective and based on the declarative, this work is the first to our
knowledge to highlight this benefit of treatment and to evaluate botulinum toxin over such a long period (11
years). Conclusion There appears to be an increase in the duration of efficacy of botulinum toxin A
injections with the repetition of injections in patients with primary axillary hyperhidrosis. The reasons for this
effect may be linked to the mechanism of action of botulinum toxin, and may improve our understanding of
its pharmacologic effects.
EGFR inhibiters Erlotinib and Lapatinib ameliorate epidermal blistering in Pemphigus
vulgaris in a non-linear, V-shaped relationship
27 Nov 2013 02:54 am
Novel insights into intracellular signaling involved in pemphigus vulgaris (PV), an autoimmune blistering
disease of skin and mucous membranes, are now revealing new therapeutic approaches such as the
chemical inhibition of PV-associated signals in conjunction with standard immunosuppressive therapy.
However, extensive inhibition of signaling molecules that are required for normal tissue function and
integrity may hamper this approach. Using a neonatal PV mouse model, we demonstrate that epidermal
blistering can be prevented in a dose-dependent manner by clinically approved EGFR inhibitors Erlotinib
and Lapatinib, but only up to approximately 50% of normal EGFR activity. At lower activity, blisters again
aggravated and were highly exacerbated in mice with a conditional deletion of EGFR. Statistical analysis of
the relation between EGFR activity and the extent of skin blistering revealed the best fit with a non-linear, Vshaped curve with a median break point at 52% EGFR activity (p=0.0005). Moreover, Lapatinib (a dual
EGFR/ErbB2 inhibitor) but not Erlotinib significantly reduced blistering in the oral cavity, suggesting that
signaling mechanisms differ between PV predilection sites. Our results demonstrate that future clinical trials
evaluating EGFR/ErbB2 inhibitors in PV patients must select treatment doses that retain a specific level of
signal molecule activity. These findings may also be of relevance for cancer patients treated with EGFR
inhibitors, for whom skin lesions due to extensive EGFR inhibition represent a major threat. This article is
protected by copyright. All rights reserved.
Editorial Board
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Editors' Picks
12 Nov 2013 12:00 am
Editors' Picks
Journal of Investigative Dermatology 133, 2658 (December 2013).doi:10.1038/jid.2013.408
Effecting Professional Unity
12 Nov 2013 12:00 am
Effecting Professional Unity
Journal of Investigative Dermatology 133, 2653 (December 2013).doi:10.1038/jid.2013.380
Author: Paul R Bergstresser
Efficacy of RG1-VLP Vaccination against Infections with Genital and Cutaneous Human
Papillomaviruses
12 Nov 2013 12:00 am
Efficacy of RG1-VLP Vaccination against Infections with Genital and Cutaneous Human
Papillomaviruses
Journal of Investigative Dermatology 133, 2706 (December 2013).doi:10.1038/jid.2013.253
Authors: Christina Schellenbacher, Kihyuck Kwak, Dieter Fink, Saeed Shafti-Keramat, Bettina Huber,
Christoph Jindra, Helena Faust, Joakim Dillner, Richard B.S. Roden & Reinhard Kirnbauer
Efficacy of oregonin investigated by non-invasive evaluation in a B16 mouse melanoma
model
27 Nov 2013 04:04 am
Oregonin has been reported to act as a mediator of antibiosis, a liver-protective agent, an antioxidant, an
anti-inflammatory agent, and to prevent cancer outbreaks. B16 melanoma cells were separated with trypsinethylenediaminetetraacetic acid, resuspended in 50 μl of phosphate-buffered saline and transplanted into
the backs of 6- to 8-week-old male Balb/c nude mice through subcutaneous injection. Treatment doses of
oregonin were administered three times weekly, for 30 days from the 11th day after transplantation of the
melanoma cells, in each group. The study consisted of a control group, a dacarbazine group, an oregonin
group and a dacarbazine + oregonin group. Measurements were taken before treatment and on the 5th,
7th, 10th and 15th days after treatment for each group. Based on survival rates after transplantation, the
control group showed less than 50% survival after 20 days, while the treatment groups showed at least 50%
survival up to the 41st day.
Effluent syntaxin3 from dying cells affords protection against apoptosis in epidermal
keratinocytes
27 Nov 2013 04:04 am
Ultra-violet B (UVB)-induced oxidative stress crucially perturbs the epidermal homeostasis, and the skin is
endowed with protective mechanisms to take action against such damage. Here, we show the possible
involvement of t-SNARE protein syntaxin3, a membrane fusion mediator of cytoplasmic vesicles, and which
is released from dying keratinocytes, to play a role in this response. UVB irradiation, which generates
reactive oxidative stress in cells, was shown to lead to the keratinocyte cell death accompanied by a
release of cytoplasmic syntaxin3. We found that such extracellularly sourced syntaxin3 completely blocked
the processing of a crucial effector for apoptotic cell death, caspase-3, and thus facilitated the survival of
keratinocytes damaged by oxidative stress. These results demonstrate the latent prosurvival function of
syntaxin3 and underline the importance of intracellular molecular elements for the maintenance of
homeostasis in epidermal keratinocytes.
Emerging therapies in rosacea
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6, Supplement 1
Author(s): Alison Layton , Diane Thiboutot
Rosacea is a common skin disorder with multiple symptoms. The emergence of research that furthers
understanding of pathophysiological mechanisms has created new targets for disease treatment.
Specifically, there is a need for new treatments that address the various erythematic symptoms associated
with rosacea. Systemic and topical therapies have both yielded positive results in treating rosacea with
various medications. Subantimicrobial-dose doxycycline is one such promising treatment. Development of
novel products in the near future should help achieve more satisfactory outcomes for patients.
Epidemiologic trends in pediatric tinea capitis: A population-based study from Kaiser
Permanente Northern California
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Paradi Mirmirani , Lue-Yen Tucker
Background Epidemic levels of tinea capitis (TC) have previously been reported in children. Objective We
sought to determine new epidemiologic trends for TC among northern California children from 1998 through
2007. Methods Annual incidence of TC was based on diagnosis code or first-time antifungal prescriptions in
all children up to age 15 years at Kaiser Permanente Northern California. Results An average of 672,373
children/y met the inclusion criteria. Trend analyses showed decreases in TC by diagnosis code and by
prescriptions (73.7% and 23.7%, respectively). Girls had lower incidence rates than boys by diagnosis
(111.9 vs 146.4, P &lt; .001 for 1998, and 27.9 vs 39.9, P &lt; .001 for 2007). African Americans had the
highest incidence rates by diagnosis (447.3 in 1998 and 184.1 in 2007) compared with other ethnic groups.
Trichophyton tonsurans was the predominant organism (89.4% of all positive fungal cultures in 1998 and
91.8% in 2007). Prescriptions for griseofulvin declined, whereas the prescriptions for other antifungals
increased. Limitations This was a retrospective study. Conclusions In this cohort, there was a significant
decrease in incidence of TC over the study period. Trichophyton tonsurans continued to be the predominant
organism. These trends may be a result of improved education, recognition, diagnosis, and treatment of TC
and increased use of new oral antifungals.
Epstein–Barr Virus Infection Induces Aberrant TLR Activation Pathway and Fibroblast–
Myofibroblast Conversion in Scleroderma
14 Nov 2013 12:00 am
Epstein–Barr Virus Infection Induces Aberrant TLR Activation Pathway and Fibroblast–
Myofibroblast Conversion in Scleroderma
Journal of Investigative Dermatology advance online publication, November 14
2013.doi:10.1038/jid.2013.423
Authors: Antonella Farina, Mara Cirone, Michael York, Stefania Lenna, Cristina Padilla, Sarah Mclaughlin,
Alberto Faggioni, Robert Lafyatis, Maria Trojanowska & Giuseppina A Farina
Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle
reduction of the décolletage
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Sabrina G. Fabi , Ane Massaki , Sasima Eimpunth , Janice Pogoda , Mitchel P. Goldman
Background Laxity and rhytides are manifestations of photodamage on the chest. Objective We sought to
evaluate efficacy and safety of microfocused ultrasound with visualization treatment of décolletage laxity
and rhytides. Methods In all, 24 subjects with moderate to severe rhytides, as measured by a validated 5point photonumeric scale (Fabi/Bolton Chest Wrinkle Scale), received microfocused ultrasound with
visualization treatment. Efficacy was measured at 90 and 180 days by the Fabi/Bolton Chest Wrinkle Scale,
mid-clavicular to nipple distance, masked assessment, Physician and Subject Global Aesthetic
Improvement Scales, and patient satisfaction. Adverse events were recorded. Results Rhytides improved
over time ( P &lt; .0001), with 46% and 62% of subjects showing a 1- to 2-point improvement at days 90 and
180, respectively. Mean (SD) mid-clavicular to nipple distance decreased ( P &lt; .0001), from 20.9 (1.57)
cm to 19.8 (1.50) cm and 19.5 (1.59) cm, at days 90 and 180, respectively. At day 90, 100% were improved
by Subject Global Aesthetic Improvement Scale score ( P &lt; .0001) and 96% were improved by Physician
Global Aesthetic Improvement Scale score ( P &lt; .0001), with similar findings at day 180. All subjects were
satisfied or very satisfied at day 90, with similar results at day 180. Improvement by masked assessment at
day 90 was 71%. Limitations Single-center study, small sample size, and only Fitzpatrick skin types I and II
enrolled were limitations. Conclusion There was appreciable efficacy and patient satisfaction after a single
microfocused ultrasound with visualization treatment in wrinkle reduction and lifting of the décolletage.
Evidence for an Alternatively Spliced MITF Exon 2 Variant
14 Nov 2013 12:00 am
Evidence for an Alternatively Spliced MITF Exon 2 Variant
Journal of Investigative Dermatology advance online publication, November 14
2013.doi:10.1038/jid.2013.426
Authors: Jacinta L Simmons, Carly J Pierce & Glen M Boyle
Favre Racouchot Syndrome; A novel two- step treatment approach using the carbon
dioxide laser
20 Nov 2013 05:28 am
Background Favre Racouchot Syndrome (FRS) is both disfiguring and difficult to treat. Available medical
and surgical therapies are of variable efficacy. Most treatments do not achieve complete resolution and do
not show maintenance of therapeutic response. Objectives To assess the response to a novel two step
treatment using the carbon dioxide laser in patients with FRS. Methods Seven patients with FRS were
treated with the carbon dioxide (CO2) laser in resurfacing mode with manual expression of comedones
under infiltrative local anaesthesia. The procedure was completed in one treatment session lasting 30
minutes and the wound was left to heal by secondary intention. A topical antibiotic was applied to treated
areas and covered with a non-adherent dressing. All patients were assessed 3 months post operatively by
the operating laser surgeon and a visual assessment of clinical response to treatment in comparison to pre
treatment photographs was made. Patient satisfaction was also recorded. Results All patients achieved
complete resolution of FRS. The follow up duration for our cohort ranged from 8 months to 3 years. Two
patients required further treatment within a 2 -3 year period from initial treatment. Disease relapse was
noted over 1 year post primary treatment, both these cases were smokers and repeat treatment with similar
laser parameters maintained reproducible results. Our longest disease free follow up duration was 3 years
post-primary treatment. Laser surgeons and patients reported high levels of therapeutic benefit and
satisfaction with the results. Conclusions This two-step treatment of FRS (CO2) laser resurfacing and
manual pressure induced expression of comedones) is an effective and durable treatment for FRS with an
excellent cosmetic outcome. Long term follow up beyond 3 years is planned to determine if later recurrence
occurs with this technique. This article is protected by copyright. All rights reserved.
Fibronectin Peptides that Bind PDGF-BB Enhance Survival of Cells and Tissue under
Stress
07 Nov 2013 12:00 am
Fibronectin Peptides that Bind PDGF-BB Enhance Survival of Cells and Tissue under Stress
Journal of Investigative Dermatology advance online publication, November 7
2013.doi:10.1038/jid.2013.420
Authors: Fubao Lin, Jia Zhu, Marcia G Tonnesen, Breena R Taira, Steve A McClain, Adam J Singer &
Richard A F Clark
Filaggrin Deficiency Leads to Impaired Lipid Profile and Altered Acidification Pathways in a
3D Skin Construct
07 Nov 2013 12:00 am
Filaggrin Deficiency Leads to Impaired Lipid Profile and Altered Acidification Pathways in a 3D Skin
Construct
Journal of Investigative Dermatology advance online publication, November 7
2013.doi:10.1038/jid.2013.402
Authors: Kateřina Vávrová, Dominika Henkes, Kay Strüver, Michaela Sochorová, Barbora Školová,
Madeleine Y Witting, Wolfgang Friess, Stephan Schreml, Robert J Meier, Monika Schäfer-Korting, Joachim
W Fluhr & Sarah Küchler
Filaggrin Is a Predominant Member of the Denaturation-Resistant Nickel-Binding Proteome
of Human Epidermis
21 Nov 2013 12:00 am
Filaggrin Is a Predominant Member of the Denaturation-Resistant Nickel-Binding Proteome of
Human Epidermis
Journal of Investigative Dermatology advance online publication, November 21
2013.doi:10.1038/jid.2013.445
Authors: Katrine Ross-Hansen, Ole Østergaard, Julia T Tanassi, Jacob P Thyssen, Jeanne D Johansen,
Torkil Menné & Niels H H Heegaard
Four compartment method - a simplified and cost effective method of non-cultured
epidermal cell suspension for the treatment of vitiligo
06 Nov 2013 12:21 pm
Background Despite continued progress toward an elucidation of pathogenetic pathways in vitiligo, a
definitive cure remains elusive. Non-cultured epidermal cell suspension (NCECS) is emerging as treatment
of choice for surgical management of stable vitiligo and segmental vitiligo. NCECS is very effective in
repigmenting stable vitiligo but the technique requires an expert and support of laboratoryfacility. Method In
this paper we simplified the conventional NCECS method and made this more cost effective and simple
enough to be performed in the clinic without laboratory equipment and named this as four compartment
method (FC). 6 vitiligo patients were treated with this FC method. Results FC method for non-cultured
epidermal cell suspension is highly cost effective and simple. Six vitiligo patients were treated and results
showed marked to complete repigmentation in four patients and more than 50% repigmentation in two
patients in three months. Conclusion FC method is cost effective and simple procedure to prepare
epidermal cell suspension. In this modified method we showed that there is no need of pipette, tips,
centrifuge tube and most importantly centrifuge machine or any other laboratory equipment. This article is
protected by copyright. All rights reserved.
Frequency of melanocytic nevi in psoriatic patients is related to treatment and not to
disease severity
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Antonella Di Cesare , Assunta Riitano , Mariano Suppa , Rosaria Fidanza , Arianna Zangrilli ,
Maria Esposito , Maria Concetta Fargnoli , Sergio Chimenti , Ketty Peris
Background Few data exist on the relationship between psoriasis and melanocytic lesions. Objectives We
sought to investigate number of melanocytic nevi in psoriatic patients compared with control subjects and its
relationship with disease severity and treatment. Methods We performed a prospective study in 189
psoriatic patients and 189 control subjects. Sociodemographic and clinical data were recorded for all
participants. Results As compared with control subjects, patients had fewer nevi overall [χ2(5) = 52.24, P
&lt; .001], fewer nevi less than 5 mm [χ2(4) = 60.28, P &lt; .001], and fewer congenital nevi [χ2(1) = 10.41, P
= .002]; no differences in atypical nevi and family history of cancer, including melanoma, were observed.
Among psoriatic patients, number of biologics used was a risk factor for a higher nevus count [odds ratio
1.35 (95% CI 1.04-1.76), P = .02] whereas disease severity did not correlate with number of nevi.
Limitations Low number of psoriatic patients naïve to systemic therapies was a limitation. Conclusions
Psoriatic patients have fewer nevi than control subjects. Frequency of nevi in psoriatic patients is related to
treatment, not to disease severity.
From the Medical Board of the National Psoriasis Foundation: Vaccination in adult patients
on systemic therapy for psoriasis
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Lara Wine-Lee , Sara C. Keller , Marissa B. Wilck , Stephen J. Gluckman , Abby S. Van
Voorhees
Patients with moderate to severe psoriasis often require systemic immunomodulatory medications that
place them at risk for infection. Vaccination is a proven strategy to reduce infections. However, vaccination
rates among patients with inflammatory autoimmune conditions, including psoriasis, remain low. We review
the literature regarding vaccine-preventable illness and vaccinations commonly used in the United States in
patients older than 18 years on immunosuppressive therapies that are used in the treatment of psoriasis.
The medical board of the National Psoriasis Foundation recommends that dermatologists counsel patients
on updating vaccinations in accordance with recommendations of the Advisory Committee for Immunization
Practices as any measures taken to prevent infection can increase the safety of immunomodulatory
therapies.
Fructose 1, 6-diphosphate regulates desmosomal proteins and collagen fibres in human
skin equivalents
27 Nov 2013 04:04 am
We previously reported that fructose 1,6-diphosphate (FDP), a glycolytic metabolite, alleviates ultraviolet Binduced oxidative skin damage. Here, we further examined the effects of FDP on skin. FDP decreased the
number of desmosomes, whereas it increased collagen fibres in skin equivalents (SEs). FDP significantly
decreased the expression of corneodesmosomal components such as desmoglein 1 (DSG1), desmocollin 1
(DSC1) and corneodesmosin (CDSN), and desquamation-related proteases, kallikrein 5 (KLK 5) and
kallikrein 7 (KLK7) in normal human epidermal keratinocytes (NHEKs). In addition, FDP treatment
increased the phosphorylation of p38 MAPK, but the decreased expression of corneodesmosomal
components is not recovered by the treatment of p38 MAPK inhibitors. Interestingly, FDP diminished the
amplitude of Ca2+ fluxes through down-regulation of SERCA2. Taken together, these results suggested
that FDP induced a decrease in desmosomes and an increase in collagen fibres similar to the process of
chemical peeling, the most common treatments for ageing skin.
GRowing an Epidermal Tumor
12 Nov 2013 12:00 am
GRowing an Epidermal Tumor
Journal of Investigative Dermatology 133, 2659 (December 2013).doi:10.1038/jid.2013.350
Authors: Wendy B Bollag & Carlos M Isales
Galectin-7, induced by cis-urocanic acid and ultraviolet B irradiation, down-modulates
cytokine production by T lymphocytes
27 Nov 2013 04:04 am
Urocanic acid (UCA) is an epidermal chromophore that undergoes trans to cis isomerization after UVB
irradiation. cis-UCA is a potent inhibitor of cutaneous acquired immunity. The aim of this study was to
explore the genes, which are upregulated by cis-UCA in normal human epidermal keratinocytes (NHEK)
and investigated its role in vitro using human T-lymphocyte cell line, Jurkat cells. DNA microarray analysis
and real-time PCR investigation revealed that cis-UCA, not trans-UCA, increased the expression of a gene
encoding a β-galactoside-binding lectin, galectin-7, LGALS7B. Immunohistochemical study demonstrated
that galectin-7 was highly expressed in the epidermis in the patients with actinic keratosis. Galectin-7
administration upregulated apoptosis and inhibited the expression of interleukin-2 (IL2) and interferon-γ
(IFNG) mRNA in Jurkat cells. Taken together, galectin-7 may play important roles in downregulating the
functions of T lymphocytes after UVB irradiation and can be developed into novel immunosuppressive
therapies for inflammatory skin diseases.
Gentian Violet: a 19th century drug re-emerges in the 21st century
27 Nov 2013 04:04 am
Gentian violet (GV) has a long and varied history as a medicinal agent. Historically used as an antibacterial
and antifungal, recent reports have shown its utility as an antitypranosomal, antiviral and anti-angiogenic
agent. The objective of this article is to summarize evidence regarding the efficacy and safety of GV use in
dermatology. Recent discoveries have found novel targets of GV, namely NADPH oxidase in mammalian
cells and thioredoxin reductase 2 in bacterial, fungal and parasitic cells. These discoveries have expanded
the use of GV in the 21st century. Given that GV is well tolerated, effective and inexpensive, its use in
dermatology is predicted to increase.
Guidelines of care for the management of primary cutaneous melanoma
01 Dec 2013 06:20 am
Publication date: December 2013
Source:Journal of the American Academy of Dermatology, Volume 69, Issue 6
Author(s): Timothy M. Johnson
Hair cycle control by leptin as a new anagen inducer
16 Nov 2013 01:02 am
Our purpose is to clarify the physiological role of leptin in hair cycle since leptin reportedly causes activation
of Stat3, which is indispensable for hair cycling. While hair follicles in dorsal skin of 5-week old C57/BL6
mice had progressed to late anagen phase, those in dorsal skin of 5-week old leptin receptor deficient db/db
mice remained in the first telogen and later entered the anagen at postnatal day 40, indicating that
deficiency in leptin receptor signaling delayed the second hair cycle progression. Next, we shaved dorsal
hairs on wild-type mice at postnatal 7 weeks and injected skin with mouse leptin or a mock. After 20 days,
although mock injection showed no effect, hair growth occurred around leptin injection area. Human leptin
fragment (aa22-56) had similar effects. Although the hair cycle of ob/ob mice was similar to that of wild-type
mice, injection of mouse leptin on ob/ob mice at postnatal 7 weeks induced anagen transition.
Immunohistochemically, leptin is expressed in hair follicles from catagen to early anagen in wild type mice,
suggesting that leptin is an anagen inducer in vivo. Phosphorylation of Erk, Jak2 and Stat3 in human
keratinocytes was stimulated by leptin and leptin fragment. In addition, RT-PCR and ELISA showed that
production of leptin by human dermal papilla cells increased under hypoxic condition, suggesting that
hypoxia in catagen/telogen phase promotes leptin production, preparing for entry into the next anagen. In
conclusion, leptin, a well-known adipokine, acts as an anagen inducer and represents a new player in hair
biology. This article is protected by copyright. All rights reserved.
Heterozygous Mutations in AAGAB Cause Type 1 Punctate Palmoplantar Keratoderma with
Evidence for Increased Growth Factor Signaling
12 Nov 2013 12:00 am
Heterozygous Mutations in AAGAB Cause Type 1 Punctate Palmoplantar Keratoderma with
Evidence for Increased Growth Factor Signaling
Journal of Investigative Dermatology 133, 2805 (December 2013).doi:10.1038/jid.2013.243
Authors: Elizabeth Pöhler, Mozheh Zamiri, Catriona P Harkins, Julio C Salas-Alanis, William Perkins,
Frances J D Smith, W H Irwin McLean & Sara J Brown
Talk to us about our bulletins!
We'd love to hear what you think of this bulletin. Is it too vague? Too specific? Spot on? Is it doing the job or
missing the mark?
Is there a resource we've missed out? Do you need a bulletin on a different topic?
Please let us know (contact details above) so that we can provide you with a better service! We currently
have bulletins on the following topics, available weekly or monthly, by email or post:
A&E
Haematology
Patient Safety & Clinical Risk
Anaesthesia
Health Psychology
Physiotherapy
Brain Injury
Heart Failure
Plastic & Reconstructive Surgery
Breast Care
Management & Quality
Primary Care
CAMHS
Medical Education
Psychodynamics
Cardiology
Mental Health Commissioning
Public Health
Care of the elderly
Mental Health Nursing
Renal Care
Continence
Neurosurgery
Renal Nursing
Critical Care Nursing
Obstetrics & Gynaecology
Safeguarding Children
Dementia
Oncology
Sexual Health
Diabetes
Ophthalmology
Substance Misuse
Dietetics
Paediatric Burns
Vascular Surgery
End-of-life Care
Paediatrics
Wound Care
ENT
Copyright © 2013 North Bristol NHS Trust Library & Information Service, All rights reserved.
You are receiving this email because you opted in via the library service at Frenchay, Southmead or South
Plaza.
Our mailing address is:
North Bristol NHS Trust Library & Information Service
1st Floor, Learning & Research, Southmead Hospital
Westbury-on-Trym
Bristol, Eng BS10 5NB
United Kingdom
Add us to your address book
unsubscribe from this list update subscription preferences