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Booker B, Mintoff D, Pace NP, Degaetano J, Boffa MJ, Betts A. Tattoo-associated acquired cutaneous lymphangiectasia: A complication of axillary hidradenitis suppurativa? J Eur Acad Dermatol Venereol 2024. [PMID: 38523476 DOI: 10.1111/jdv.19969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Bettina Booker
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Nikolai P Pace
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
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Mintoff D, Pace NP. Differences in hidradenitis suppurativa patterns of cutaneous involvement between sexes: Insights from a cross-sectional study. Hum Immunol 2024; 85:110764. [PMID: 38320910 DOI: 10.1016/j.humimm.2024.110764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/10/2024] [Accepted: 02/02/2024] [Indexed: 02/08/2024]
Abstract
Hidradenitis suppurativa is a chronic, inflammatory condition of the pilosebaceous unit in which patients manifest multiple, painful cutaneous nodules, abscesses and tunnels. These lesions are described to affect the intertriginous zones, however, the condition exhibits significant phenotypic variability. Such variability is influenced by the patients lifestyle, genetic predisposition and sex. In this cross-sectional study, we investigate sex differences in patterns of hidradenitis suppurativa skin involvement, specifically at site of first involvement and most bothersome cutaneous site of involvement.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta; Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Nikolai P Pace
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta; Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
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Borg Grech S, Mintoff D, Scerri L. The punctum sign in epidermal cyst. Clin Exp Dermatol 2024; 49:275-276. [PMID: 37952189 DOI: 10.1093/ced/llad380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023]
Abstract
Epidermal cysts, commonly seen in everyday practice, classically present with a readily identifiable central punctum. However, this is lacking in some patients, making diagnosis more difficult. We describe how to apply pressure between index finger and thumb to the cyst, thus revealing the punctum and enabling a definitive diagnosis.
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Affiliation(s)
- Sarah Borg Grech
- Department of Dermatology, Mater Dei Hospital, Triq Dun Karm, Msida, Malta
| | - Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Triq Dun Karm, Msida, Malta
| | - Lawrence Scerri
- Department of Dermatology, Mater Dei Hospital, Triq Dun Karm, Msida, Malta
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Mintoff D, Borg I, Pace NP. NOD2 at the interface of hidradenitis suppurativa and inflammatory bowel disease-An in silico analysis. Exp Dermatol 2024; 33:e14928. [PMID: 37694954 DOI: 10.1111/exd.14928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Isabella Borg
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Pathology, Section of Clinical Genetics, Mater Dei Hospital, Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Nikolai P Pace
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Kozera EK, Porter M, Paek SY, Mintoff D, McMeniman E, Oon HH, Chandran NS, Glasenhardt K, Ring HC, Frew JW. Infectious Disease Screening Prior to Systemic Immunomodulatory Therapy in Hidradenitis Suppurativa: Consensus Guidelines from the Asia-Pacific Hidradenitis Suppurativa Foundation. Dermatology 2023:000534575. [PMID: 37963431 DOI: 10.1159/000534575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Current infectious disease screening recommendations for hidradenitis suppurativa (HS) are adopted from recommendations in chronic plaque psoriasis. No HS-specific guidelines for infectious disease screening prior to immunomodulatory therapy have been developed. OBJECTIVES To establish an expert Delphi consensus of recommendations regarding infectious disease screening prior to systemic immunomodulatory therapy in HS. METHODS Participants were identified via recent publications in the field and were sent a questionnaire regarding infectious diseases encountered in the setting of HS, and opinions regarding infectious disease screening prior to various systemic immunomodulatory therapies. All questions were informed by a systematic literature review regarding infections exacerbated or precipitated by immunomodulatory therapy. Questionnaire responses were followed by round-table discussion with a core group of 8 experts followed by a final round of questionnaires resulting in achievement of consensus. RESULTS 44 expert HS physicians from 12 countries on 5 continents participated in the development of the expert consensus recommendations. Consensus recommendations include screening for hepatitis B, hepatitis C and tuberculosis in all individuals with HS prior to therapy. All immunomodulatory therapies (biologic and systemic immunosuppressant therapy) should be preceded by infectious disease screening including patient and location specific considerations for endemic local diseases and high-risk activities and occupations. Clinical assessment has a significant role in determining the need for laboratory screening in the setting of many uncommon or tropical diseases such as leprosy, leishmaniasis and strongyloidiasis. CONCLUSIONS The presented consensus recommendations are the first specifically developed for pre-treatment infectious disease screening in Hidradenitis Suppurativa.
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Borg L, Mintoff D, Boffa MJ. Athena: Specialty Certificate Examination case for general dermatology and dermatology in primary healthcare. Clin Exp Dermatol 2023; 48:1194-1195. [PMID: 37379579 DOI: 10.1093/ced/llad216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]
Abstract
A 75-year-old woman presented to the dermatology clinic with a 6-month history of painful oral erosions. Clinical examination of the oral cavity revealed two intact tense bullae at the right retromolar trigone, the features of which were accentuated by white light illumination using a dermoscope. We discuss further assays, diagnosis and treatment.
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Affiliation(s)
- Luca Borg
- Department of Dermatology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta
| | - Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta
| | - Michael J Boffa
- Department of Dermatology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta
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Abstract
Importance Hidradenitis suppurativa (HS) is a complex trait that has a monogenic etiology in a subset of patients. Variation in genes that encode proteins of the γ secretase complex, particularly NCSTN, account for few patients who exhibit familial forms of HS. Thus far, extensive genotype-phenotype correlations have been lacking. Objective To establish the prevalence of the NCSTN:c.671_682del variant and explore potential genotype-phenotype associations in an ethnically Maltese HS cohort. Design, Setting, and Participants This cross-sectional study conducted from December 2021 to September 2022 included patients 18 years or older with a diagnosis of HS as defined by recurrent nodules, abscesses, and/or draining tunnels in typical (axilla, breast, groin, buttock, thighs, and inframammary folds) and less typical (scalp, ear pinnae, neck, arms, antecubital fossae) sites who were recruited from the sole national dermatology reference center servicing the Maltese archipelago. Clinical examination and targeted genetic analysis for an NCSTN deletion that was originally identified through whole-exome sequencing in a family with multigenerational disease were performed. Exposure Recruited patients were phenotyped and genotyped for the NCSTN:c.671_682del variant. Main Outcome and Measures To determine the prevalence of the NCSTN:c.671_682del variant and establish possible genotype-phenotype associations in the ethnically Maltese HS cohort. Results A total of 113 patients with HS (56 women [49.6%]) met the inclusion criteria and were enrolled in this study. The median age of disease onset was 18 years (range, 7-62 years), and the median International Hidradenitis Suppurativa Severity Score System score was 4.39 (range, 1.0-64.0). The NCSTN variant was identified in the heterozygous state in 14 patients (12.4%) from 5 unrelated, nonconsanguineous families of Maltese ethnicity. The variant was not identified in an ethnically matched reference genomic data set of disease-free individuals. Variant carriers manifested HS symptoms earlier and were more likely to exhibit a distinctive HS phenotype, which was characterized by involvement of the scalp, neck, torso, and antecubital fossae. Despite manifesting similar clinical disease severity, variant carriers were more likely to require treatment with adalimumab. Conclusions and Relevance The results of this cross-sectional study suggest that monogenic variation in NCSTN is associated with HS in a subset of patients who have a distinct, atypical phenotype.
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Affiliation(s)
- Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Nikolai Paul Pace
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Isabella Borg
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
- Medical Genetics Section, Department of Pathology, Mater Dei Hospital, Msida, Malta
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Mintoff D, Agius R, Benhadou F, Das A, Frew JW, Pace NP. Obesity and hidradenitis suppurativa: targeting meta-inflammation for therapeutic gain. Clin Exp Dermatol 2023; 48:984-990. [PMID: 37171791 DOI: 10.1093/ced/llad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/24/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory condition of the pilosebaceous unit. The typical patient with HS is characterized as someone with obesity, who smokes and who has nodules, abscesses and/or draining tunnels predominantly distributed in intertriginous skin. It has been established that lifestyle and genetic factors are the main pathophysiological drivers of HS. In this critical review, we explore the interrelatedness of meta-inflammation, obesity and HS and discuss if and how this relationship may be manipulated for a therapeutic end.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology
- Department of Pathology, Faculty of Medicine and Surgery
| | - Rachel Agius
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, Malta
- Faculty of Medicine and Surgery
| | - Farida Benhadou
- Department of Dermatology, Hôpital Erasme, Universite Libre de Bruxelles, Bruxelles, Belgium
| | - Anupam Das
- Department of Dermatology, Venereology and Leprosy; KPC Medical College & Hospital, Kolkata, India
| | - John W Frew
- Laboratory of Translational Cutaneous Medicine, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
| | - Nikolai P Pace
- Faculty of Medicine and Surgery
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
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Mintoff D, Agius R, Fava S, Pace NP. Investigating Adiposity-Related Metabolic Health Phenotypes in Patients with Hidradenitis Suppurativa: A Cross-Sectional Study. J Clin Med 2023; 12:4847. [PMID: 37510962 PMCID: PMC10381271 DOI: 10.3390/jcm12144847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/20/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Obesity and hidradenitis suppurativa (HS) are related through meta-inflammation and are both associated with increased cardiometabolic risk. Notwithstanding, cardiometabolic pathology is not uniform in obesity and a subset of individuals with excess adiposity exhibit a healthy metabolic profile. Whilst the incidence of cardiometabolic endpoints and transitions across different adiposity-related body composition phenotypes within several populations and across different ethnicities have been investigated, data regarding metabolic health (MetH) and body composition phenotypes in individuals with HS are lacking. The objective of this study was to evaluate the relationship between different body composition phenotypes in individuals with HS. METHODS This was a cross-sectional study of 632 individuals with and without HS from a population with a high prevalence of both obesity and HS. A total of four body composition phenotypes were generated based on BMI and metabolic status (defined using either the metabolic syndrome definition or the homeostasis model of insulin resistance (HOMA-IR)): metabolically healthy overweight/obese (MHOWOB), metabolically unhealthy overweight/obese (MUOWOB), metabolically healthy normal weight (MHNW), and metabolically unhealthy normal weight (MUNW). RESULTS Generally, subjects with HS exhibited a worse metabolic profile with higher levels of indices of central adiposity measures (including Visceral Adiposity Index and waist circumference), systolic blood pressure and markers of insulin resistance, as well as a higher prevalence of the metabolic syndrome. Moreover, when sub-stratified into the different body composition phenotypes, individuals with HS typically also demonstrated adverse metabolic characteristics relative to controls matched for both adiposity and metabolic health, particularly in the normal weight category and despite being classified as metabolically healthy. Being metabolically unhealthy in addition to being overweight/obese increases an individual's risk of HS. CONCLUSIONS Metabolic risk-assessment should be prioritized in the clinical management of individuals with HS even in those who are lean. Patients attending HS clinics provide a valuable opportunity for targeted cardiovascular risk reduction with respect to the management of both obesity and metabolic health.
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Affiliation(s)
- Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Department of Dermatology, Mater Dei Hospital, MSD2090 Msida, Malta
| | - Rachel Agius
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Department of Medicine, Mater Dei Hospital, MSD2090 Msida, Malta
| | - Stephen Fava
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Department of Medicine, Mater Dei Hospital, MSD2090 Msida, Malta
| | - Nikolai P Pace
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, MSD2080 Msida, Malta
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Kuiper JJ, Prinz JC, Stratikos E, Kuśnierczyk P, Arakawa A, Springer S, Mintoff D, Padjen I, Shumnalieva R, Vural S, Kötter I, van de Sande MG, Boyvat A, de Boer JH, Bertsias G, de Vries N, Krieckaert CL, Leal I, Vidovič Valentinčič N, Tugal-Tutkun I, El Khaldi Ahanach H, Costantino F, Glatigny S, Mrazovac Zimak D, Lötscher F, Kerstens FG, Bakula M, Viera Sousa E, Böhm P, Bosman K, Kenna TJ, Powis SJ, Breban M, Gul A, Bowes J, Lories RJ, Nowatzky J, Wolbink GJ, McGonagle DG, Turkstra F. EULAR study group on ‘MHC-I-opathy’: identifying disease-overarching mechanisms across disciplines and borders. Ann Rheum Dis 2023:ard-2022-222852. [PMID: 36987655 DOI: 10.1136/ard-2022-222852] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/25/2023] [Indexed: 03/29/2023]
Abstract
The ‘MHC-I (major histocompatibility complex class I)-opathy’ concept describes a family of inflammatory conditions with overlapping clinical manifestations and a strong genetic link to the MHC-I antigen presentation pathway. Classical MHC-I-opathies such as spondyloarthritis, Behçet’s disease, psoriasis and birdshot uveitis are widely recognised for their strong association with certain MHC-I alleles and gene variants of the antigen processing aminopeptidases ERAP1 and ERAP2 that implicates altered MHC-I peptide presentation to CD8+T cells in the pathogenesis. Progress in understanding the cause and treatment of these disorders is hampered by patient phenotypic heterogeneity and lack of systematic investigation of the MHC-I pathway.Here, we discuss new insights into the biology of MHC-I-opathies that strongly advocate for disease-overarching and integrated molecular and clinical investigation to decipher underlying disease mechanisms. Because this requires transformative multidisciplinary collaboration, we introduce the EULAR study group on MHC-I-opathies to unite clinical expertise in rheumatology, dermatology and ophthalmology, with fundamental and translational researchers from multiple disciplines such as immunology, genomics and proteomics, alongside patient partners. We prioritise standardisation of disease phenotypes and scientific nomenclature and propose interdisciplinary genetic and translational studies to exploit emerging therapeutic strategies to understand MHC-I-mediated disease mechanisms. These collaborative efforts are required to address outstanding questions in the etiopathogenesis of MHC-I-opathies towards improving patient treatment and prognostication.
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Affiliation(s)
- Jonas Jw Kuiper
- Department of Ophthalmology, Center for Translational Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Jörg C Prinz
- University Hospital, department of Dermatology and Allergy, Ludwig Maximilians University Munich, Munchen, Germany
| | - Efstratios Stratikos
- Laboratory of Biochemistry, Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Piotr Kuśnierczyk
- Laboratory of Immunogenetics and Tissue Immunology, Institute of Immunology and Experimental Therapy Ludwik Hirszfeld Polish Academy of Sciences, Wroclaw, Poland
| | - Akiko Arakawa
- University Hospital, department of Dermatology and Allergy, Ludwig Maximilians University Munich, Munchen, Germany
| | | | - Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
- Department of Pathology, University of Malta Faculty of Medicine and Surgery, Msida, Malta
| | - Ivan Padjen
- Division of Clinical Immunology and Rheumatology, University Hospital Centre Zagreb Department of Internal Medicine, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Russka Shumnalieva
- Clinic of Rheumatology, Department of Rheumatology, Medical University of Sofia, Sofia, Bulgaria
| | - Seçil Vural
- School of Medicine, Department of Dermatology, Koç University, Istanbul, Turkey
| | - Ina Kötter
- Clinic for Rheumatology and Immunology, Bad Bramdsted Hospital, Bad Bramstedt, Germany
- Division of Rheumatology and Systemic Inflammatory Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marleen G van de Sande
- University of Amsterdam, Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Institute for Infection & Immunity, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
- Amsterdam Rheumatology and Immunology Center (ARC) | Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ayşe Boyvat
- Department of Dermatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Joke H de Boer
- Department of Ophthalmology, Center for Translational Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - George Bertsias
- Department of Rheumatology and Clinical Immunology, University of Crete School of Medicine, Iraklio, Greece
- Laboratory of Autoimmunity-Inflammation, Institute of Molecular Biology and Biotechnology, Heraklion, Greece
| | - Niek de Vries
- University of Amsterdam, Department of Rheumatology & Clinical Immunology and Department of Experimental Immunology, Amsterdam Institute for Infection & Immunity, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
- Amsterdam Rheumatology and Immunology Center (ARC) | Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Charlotte Lm Krieckaert
- Amsterdam Rheumatology and immunology Center (ARC)| Reade, Amsterdam, The Netherlands
- Department of Rheumatology, Reade Hoofdlocatie Dr Jan van Breemenstraat, Amsterdam, The Netherlands
| | - Inês Leal
- Department of Ophthalmology, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal
- Centro de Estudeos das Ciencias da Visão, Universidade de Lisboa Faculdade de Medicina, Lisboa, Portugal
| | - Nataša Vidovič Valentinčič
- University Eye Clinic, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Hanane El Khaldi Ahanach
- Departement of Ophthalmology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
- Department of Ophthalmology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Félicie Costantino
- Service de Rheumatology, Hospital Ambroise-Pare, Boulogne-Billancourt, France
- Infection & Inflammation, UMR 1173, Inserm, UVSQ, University Paris-Saclay, Montigny-le-Bretonneux, France
| | - Simon Glatigny
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Université Paris Saclay, Montigny-le-Bretonneux, France
- Laboratoire d'Excellence Inflamex, Paris, France
| | | | - Fabian Lötscher
- Department of Rheumatology and Immunology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland
| | - Floor G Kerstens
- Amsterdam Rheumatology and immunology Center (ARC)| Reade, Amsterdam, The Netherlands
- Department of Rheumatology, Reade Hoofdlocatie Dr Jan van Breemenstraat, Amsterdam, The Netherlands
| | - Marija Bakula
- Division of Clinical Immunology and Rheumatology, University Hospital Centre Zagreb Department of Internal Medicine, Zagreb, Croatia
| | - Elsa Viera Sousa
- Rheumatology Research Unit Molecular João Lobo Antunes, University of Lisbon Medical Faculty, Lisboa, Portugal
- Rheumatology DepartmentSanta Maria Centro Hospital, Academic Medical Centre of Lisbon, Lisboa, Portugal
| | - Peter Böhm
- Patientpartner, German League against Rheumatism, Bonn, Germany
| | - Kees Bosman
- Patientpartner, Nationale Vereniging ReumaZorg, Nijmegen, The Netherlands
| | - Tony J Kenna
- Translational Research Institute, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Simon J Powis
- School of Medicine, University of St Andrews School of Medicine, St Andrews, UK
| | - Maxime Breban
- Service de Rheumatology, Hospital Ambroise-Pare, Boulogne-Billancourt, France
- Infection & Inflammation, UMR 1173, Inserm, UVSQ, University Paris-Saclay, Montigny-le-Bretonneux, France
| | - Ahmet Gul
- Division of Rheumatology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - John Bowes
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Center, The University of Manchester, Manchester, UK
- NIHR Manchester Musculoskeletal Biomedical Research Unit, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rik Ju Lories
- Department of Rheumatology, KU Leuven University Hospitals Leuven, Leuven, Belgium
- Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Johannes Nowatzky
- Department of Medicine, Division of Rheumatology, NYU Langone Behçet's Disease Program, NYU Langone Ocular Rheumatology Program, New York University Grossman School of Medicine, New York University, New York, New York, USA
- Department of Pathology, New York University Grossman School of Medicine, New York, New York, USA
| | - Gerrit Jan Wolbink
- Amsterdam Rheumatology and immunology Center (ARC)| Reade, Amsterdam, The Netherlands
- Department Immunopathology, Sanquin Research, Amsterdam, The Netherlands
| | - Dennis G McGonagle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Franktien Turkstra
- Amsterdam Rheumatology and immunology Center (ARC)| Reade, Amsterdam, The Netherlands
- Department of Rheumatology, Reade Hoofdlocatie Dr Jan van Breemenstraat, Amsterdam, The Netherlands
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Mintoff D, Pace NP, Borg I. Management of patients with hidradenitis suppurativa having underlying genetic variation: a systematic review and a call for precision medicine. Clin Exp Dermatol 2023; 48:67-72. [PMID: 36630659 DOI: 10.1093/ced/llac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 01/13/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory condition of the pilosebaceous unit characterized by inflammation and hyperkeratinization. A small but significant proportion of patients with HS have a strong genetic susceptibility to (or a syndromic form of) the disease. Current HS treatment guidelines prioritize patients who manifest classic HS and may therefore not be suitable for the minority of patients harbouring genetically driven forms of disease. In this manuscript, we review the extant literature with regards to therapeutic strategies used for patients with HS having disease-associated genetic variants and syndromic forms of the condition. The findings of this review suggest that patients with HS harbouring underlying genetic variants may not be adequately represented in current European and British HS treatment guidelines. Moreover, these patients may be less responsive to the recommended therapeutic options. We therefore make recommendations for future therapeutic guidelines to incorporate considerations for the management of this patient subset.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Malta.,Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Malta
| | - Nikolai P Pace
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Malta.,Centre for Molecular Medicine and Biobanking, University of Malta, Malta
| | - Isabella Borg
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Malta.,Centre for Molecular Medicine and Biobanking, University of Malta, Malta.,Department of Pathology, Mater Dei Hospital, Malta
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Chernyshov PV, Sampogna F, Zouboulis CC, Boffa MJ, Marron SE, Manolache L, Pustišek N, Bettoli V, Koumaki D, Chubar O, Pochynok TV, Mintoff D, Bonitsis NG, Spillekom-van Koulil S, Driessen RJB, Chernyshov AV, Bewley AP, Evers AWM, Chernyshov IP, Tomas-Aragones L. Which Health-Related Quality of Life Items Most Affect Acne Patients? Dermatology 2022; 239:267-272. [PMID: 36476839 DOI: 10.1159/000526602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/06/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) assessment in patients with acne is recommended by several national guidelines. There are several acne-specific HRQoL instruments. OBJECTIVES Participants of the European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on QoL and Patient Oriented Outcomes (PO) and Acne, Rosacea, and Hidradenitis Suppurativa (ARHS) agreed to scrutinize aspects of existing acne-specific HRQoL instruments for their relevance in international study. METHODS Consensus agreement on items related to QoL was reached after an independent assessment by seven experts from the EADV TFs on QoL and PO, and a list of 97 items was prepared and proposed to a group of acne patients. In order to have data from patients to check if any important topics were overseen, another group of acne patients from participating countries was asked to list how acne influenced different aspects of their lives. RESULTS Based on results obtained from 601 acne patients from nine countries, most of the items and topics showed low relevance for acne patients especially during the previous month or shorter time periods. Based on percentage of relevance and factor analysis, short (6 items) and long (45 items) lists of the most relevant topics were formed. CONCLUSION Most of the items and topics from the initial list showed low relevance for acne patients. None of the identified acne-specific HRQoL instruments contain all the items that were deemed most relevant to acne patients. For this reason, participating members of the EADV TFs on QoL and PO, and ARHs are in the process of developing a new acne-specific HRQoL instrument.
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Affiliation(s)
- Pavel V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - Francesca Sampogna
- Clinical Epidemiology Unit, Istituto Dermopatico Dell'Immacolata IDI-IRCCS, Rome, Italy
| | - Christos C Zouboulis
- Department of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences, Brandenburg, Dessau, Germany
| | | | - Servando E Marron
- Department of Dermatology, University Hospital Miguel Servet, Aragon Psychodermatology Research Group Associated to Aragon Health Sciences Institute (IACS), Zaragoza, Spain
| | | | - Nives Pustišek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - Vincenzo Bettoli
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Dimitra Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Greece
| | - Olha Chubar
- Kiev City Clinical Dermatovenereologic Hospital, Kiev, Ukraine
| | - Tetiana V Pochynok
- Department of Pediatrics number 1, National Medical University, Kiev, Ukraine
| | - Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Nikolaos G Bonitsis
- Department of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences, Brandenburg, Dessau, Germany.,Haut- und Lasercentrum Potsdam-Berlin, Potsdam, Germany
| | - Saskia Spillekom-van Koulil
- Department of Medical Psychology, Radboud University Medical Center Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Rieke J B Driessen
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andriy V Chernyshov
- Department of Cellular Radiobiology, State Institution "National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine", Kiev, Ukraine
| | - Anthony Paul Bewley
- Barts Health NHS Trust, London, UK.,Department of Dermatology, Queen Mary University, London, UK
| | - Andrea W M Evers
- Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, The Netherlands
| | | | - Lucia Tomas-Aragones
- Department of Psychology, University of Zaragoza, Aragon Health Sciences Institute (IACS), Zaragoza, Spain
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13
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Mintoff D, Pace NP, Borg I. Interpreting the spectrum of gamma-secretase complex missense variation in the context of hidradenitis suppurativa—An in-silico study. Front Genet 2022; 13:962449. [PMID: 36118898 PMCID: PMC9478468 DOI: 10.3389/fgene.2022.962449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a disease of the pilosebaceous unit characterized by recurrent nodules, abscesses and draining tunnels with a predilection to intertriginous skin. The pathophysiology of HS is complex. However, it is known that inflammation and hyperkeratinization at the hair follicle play crucial roles in disease manifestation. Genetic and environmental factors are considered the main drivers of these two pathophysiological processes. Despite a considerable proportion of patients having a positive family history of disease, only a minority of patients suffering from HS have been found to harbor monogenic variants which segregate to affected kindreds. Most of these variants are in the ɣ secretase complex (GSC) protein-coding genes. In this manuscript, we set out to characterize the burden of missense pathogenic variants in healthy reference population using large scale genomic dataset thereby providing a standard for comparing genomic variation in GSC protein-coding genes in the HS patient cohort.
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Affiliation(s)
- Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Nikolai P. Pace
- Centre for Molecular Biology and Biobanking, University of Malta, Msida, Malta
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- *Correspondence: Nikolai P. Pace,
| | - Isabella Borg
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Centre for Molecular Biology and Biobanking, University of Malta, Msida, Malta
- Department of Pathology, Mater Dei Hospital, Msida, Malta
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14
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Guillem P, Mintoff D, Kabbani M, Cogan E, Vlaeminck-Guillem V, Duquesne A, Benhadou F. Case Report: Comorbid Hyper-IgD Syndrome and Hidradenitis Suppurativa - A New Syndromic Form of HS? A Report of Two Cases. Front Immunol 2022; 13:883811. [PMID: 35720358 PMCID: PMC9204359 DOI: 10.3389/fimmu.2022.883811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Hidradenitis Suppurativa (HS) is a chronic suppurative disease of the pilosebaceous unit. The current model of HS pathophysiology describes the condition as the product of hyperkeratinisation and inflammation at the hair follicular unit. Environmental factors (such as smoking and obesity), gender, genetic predisposition, and skin dysbiosis are considered the main pathogenic drivers of the disease. Autoinflammatory syndromes associated with HS are rare but may help to highlight the potential roles of autoinflammation and dysregulated innate immune system in HS. Therefore, it is of major relevance to increase the awareness about these diseases in order to improve the understanding of the disease and to optimize the management of the patients. Herein, we report for the first time, to our knowledge, two clinical cases of Hyper-IgD syndrome-associated HS. Hyper-IgD is an autoinflammatory syndrome caused by a mevalonate kinase deficiency (MKD), a key kinase in the sterol and isoprenoid production pathway. We describe the potentially shared pathophysiological mechanisms underpinning comorbid MKD-HS and propose therapeutic options for the management of these patients.
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Affiliation(s)
- Philippe Guillem
- Department of Surgery, Clinique du Val d'Ouest, Lyon, France.,ResoVerneuil, Paris, France.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - Dillon Mintoff
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Mater Dei Hospital, Msida, Malta.,Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Mariam Kabbani
- Department of Dermatology, Hôpital Universitaire Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Elie Cogan
- Department of Internal Medicine, Hôpital Universitaire Erasme, Université Libre de Bruxelles, Brussels, Belgium.,Departement of Internal Medecine, Hôpital Delta, CHIREC, Brussels, Belgium
| | - Virginie Vlaeminck-Guillem
- Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de 9 Recherche en Cancérologie de Lyon, Lyon, France.,Centre de Biologie Sud, Hôpital Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Agnes Duquesne
- Department of Paediatric Nephrology, Rheumatology and Dermatology, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Farida Benhadou
- ResoVerneuil, Paris, France.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Hôpital Universitaire Erasme, Université Libre de Bruxelles, Brussels, Belgium
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15
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Mintoff D, Pisani D, Livori N, Said‐Huntingford I, Baldacchino G. SARS‐CoV‐2 mRNA booster vaccine‐associated lichenoid drug eruption. J Eur Acad Dermatol Venereol 2022; 36:e617-e619. [PMID: 35429052 PMCID: PMC9114908 DOI: 10.1111/jdv.18149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Affiliation(s)
| | - David Pisani
- Division of Histopathology Department of Pathology Mater Dei Hospital Malta
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16
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Abstract
Hidradenitis suppurativa is a chronic, suppurative condition of the pilosebaceous unit manifesting as painful nodules, abscesses, and sinus tracts mostly in, but not limited to, intertriginous skin. Great strides have been made at elucidating the pathophysiology of hidradenitis suppurativa, which appears to be the product of hyperkeratinization and inflammation brought about by environmental factors and a genetic predisposition. The identification of familial hidradenitis suppurativa has sparked research aimed at identifying underlying pathogenic variants in patients who harbor them. The objective of this review is to provide a broad overview of the role of genetics in various aspects of hidradenitis suppurativa, specifically the pathophysiology, diagnosis, and clinical application.
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Affiliation(s)
- Nikolai Paul Pace
- Center for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Isabella Borg
- Center for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Pathology, Mater Dei Hospital, Msida, Malta
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17
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Vella S, Aquilina N, Mintoff D, Fenech VA. Vesicobullae and fever. BMJ Case Rep 2022; 15:e248893. [PMID: 35292551 PMCID: PMC8928253 DOI: 10.1136/bcr-2022-248893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/04/2022] Open
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18
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Mintoff D, Pace NP, Al‐Kawlani B, Bauer P, Borg I. Co‐Morbid Palmoplantar Keratoderma Type 1A and Loeys‐Dietz Syndrome Type 3 in a Patient with a Chromosome 15 Microdeletion. J Eur Acad Dermatol Venereol 2022; 36:e448-e451. [DOI: 10.1111/jdv.17942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dillon Mintoff
- Department of Pathology Faculty of Medicine and Surgery University of Malta
- Department of Dermatology Mater Dei Hospital Malta
| | - Nikolai P Pace
- Centre for Molecular Medicine and Biobanking Faculty of Medicine and Surgery University of Malta
| | | | | | - Isabella Borg
- Department of Pathology Faculty of Medicine and Surgery University of Malta
- Centre for Molecular Medicine and Biobanking Faculty of Medicine and Surgery University of Malta
- Medical Genetics Unit Department of Pathology Mater Dei Hospital Malta
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19
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Der Sarkissian S, Hessam S, Kirby JS, Lowes MA, Mintoff D, Naik HB, Ring HC, Suyien NC, Frew JW. Identification of Biomarkers and Critical Evaluation of Biomarker Validation in Hidradenitis Suppurativa: A Systematic Review. JAMA Dermatol 2022; 158:300-313. [PMID: 35044423 DOI: 10.1001/jamadermatol.2021.4926] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Importance The identification and validation of biomarkers in hidradenitis suppurativa (HS) has potential to improve the understanding and management of this chronic, burdensome disease. Objective To systematically identify all known HS biomarkers, categorize them by biomarker type, and critically evaluate their validity according to established criteria. Evidence Review Eligibility criteria for this review (PROSPERO Registration 230830) included randomized clinical trials, uncontrolled clinical trials, cohort studies, case-control studies, and other observational studies with no restrictions of patient age, sex, race or ethnicity, or language of publication up until December 31, 2020. All articles were categorized into biomarker type, defined using the US Food and Drug Administration Biomarkers, Endpoints, and other Tools (BEST) glossary. Assessment of each identified biomarker was undertaken in line with the US Food and Drug Administration and European Medicines Agency guidelines for the validation of proposed biomarkers. Assessment of the strength of overall data regarding individual biomarkers was undertaken using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Findings A total of 3953 nonduplicate articles were screened, of which 1429 articles were retrieved based on the include/exclusion criteria applied. After full-text screen and data extraction, 106 articles were included in this review. The evidence of strength of 6 categories of biomarkers (susceptibility/risk, diagnostic, monitoring, predictive, prognostic, and pharmacodynamic/response biomarkers) was assessed using GRADE criteria. A total of 48 biomarkers were identified with a minimum GRADE rating of moderate. Only 1 diagnostic (serum IL-2R), 1 monitoring (dermal Doppler vascularity), and 2 predictive biomarkers (epithelialized tunnels and positive family history of HS) achieved a GRADE rating of high. None of the identified biomarkers had sufficient clinical validity to be recommended for routine use in the clinical setting. Conclusions and Relevance Major barriers to the identification, validation, and introduction of routine biomarkers in the management of HS include lack of independent biomarker validation studies (especially assumption-free "omics"-based techniques); insufficient assessment of collinearity between identified or proposed biomarkers; and a lack of routine integration of biomarkers into the structure of clinical trials. International consensus among researchers, clinicians, and pharmaceutical stakeholders is required to standardize goals and methods and encourage biomarker integration into future HS clinical trials. This systematic review presents a number of priorities for near-term future research to overcome such barriers and limitations of biomarkers in HS.
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Affiliation(s)
| | - Schapoor Hessam
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Joslyn S Kirby
- Department of Dermatology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | | | - Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Haley B Naik
- Department of Dermatology, University of California San Francisco.,Associate Editor, JAMA Dermatology
| | - Hans Christian Ring
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Nisha Chandran Suyien
- Division of Dermatology, Department of Medicine, National University Hospital, Singapore
| | - John W Frew
- Department of Dermatology, Liverpool Hospital, Sydney, Australia.,University of New South Wales, Sydney, Australia.,Laboratory of Translational Cutaneous Medicine, Ingham Institute of Applied Medical Research, Sydney, Australia
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20
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Borg L, Mercieca L, Mintoff D, Micallef D, Pisani D, Betts A, Scerri L. Pfizer-BioNTech SARS-CoV-2 mRNA vaccine-associated erythema multiforme. J Eur Acad Dermatol Venereol 2022; 36:e22-e24. [PMID: 34547125 DOI: 10.1111/jdv.17682] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- L Borg
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - L Mercieca
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Micallef
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Pisani
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - A Betts
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - L Scerri
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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21
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Affiliation(s)
- D. Mintoff
- Department of DermatologyMater Dei HospitalMsidaMalta
- Department of PathologyFaculty of Medicine and SurgeryUniversity of MaltaMsidaMalta
| | - L. Scerri
- Department of DermatologyMater Dei HospitalMsidaMalta
| | - A. Betts
- Division of HistopathologyDepartment of PathologyMater Dei HospitalMsidaMalta
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22
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Mintoff D, Benhadou F. Guselkumab does not appear to influence the IgG antibody response to SARS-CoV-2. Dermatol Ther 2021; 35:e15246. [PMID: 34865295 DOI: 10.1111/dth.15246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/10/2021] [Accepted: 12/02/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Farida Benhadou
- Dermatology Department, Erasme Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
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23
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Mintoff D, Borg I, Pace NP. The Clinical Relevance of the Microbiome in Hidradenitis Suppurativa: A Systematic Review. Vaccines (Basel) 2021; 9:1076. [PMID: 34696185 PMCID: PMC8537933 DOI: 10.3390/vaccines9101076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 12/21/2022] Open
Abstract
Hidradenitis suppurativa is a chronic disease of the pilosebaceous unit. The name of the condition is a testament to the presumed relationship between the disease and the microbiome. The pathophysiology of hidradenitis suppurativa is, however, complex and believed to be the product of a multifactorial interplay between the interfollicular epithelium, pilosebaceous unit, microbiome, as well as genetic and environmental factors. In this review we assimilate the existing literature regarding the role played by the human microbiome in HS in various contexts of the disease, including the pathophysiologic, therapeutic, and potentially, diagnostic as well prognostic. In conclusion, the role played by the microbiome in HS is extensive and relevant and can have bench-to-bedside applications.
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Affiliation(s)
- Dillon Mintoff
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
- Department of Dermatology, Mater Dei Hospital, Triq Id-Donaturi tad-Demm, MSD 2090 Msida, Malta
| | - Isabella Borg
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
- Medical Genetics Unit, Department of Pathology, Mater Dei Hospital, MSD 2090 Msida, Malta
| | - Nikolai Paul Pace
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
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24
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Mintoff D, Vella SM, Ceci M, Portelli A, Savic A, Piscopo T, Scerri L. Facial pyoderma gangrenosum triggered by leishmaniasis in a patient with hidradenitis suppurativa. Clin Exp Dermatol 2021; 47:444-445. [PMID: 34554592 DOI: 10.1111/ced.14938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 12/23/2022]
Affiliation(s)
- D Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta.,Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - S M Vella
- Department of Medicine, Division of Infectious Diseases, Mater Dei Hospital, Msida, Malta
| | - M Ceci
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - A Portelli
- Department of Medicine, Division of Infectious Diseases, Mater Dei Hospital, Msida, Malta
| | - A Savic
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - T Piscopo
- Department of Medicine, Division of Infectious Diseases, Mater Dei Hospital, Msida, Malta
| | - L Scerri
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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25
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Mintoff D, Benhadou F, Pace NP, Frew JW. Metabolic syndrome and hidradenitis suppurativa: epidemiological, molecular, and therapeutic aspects. Int J Dermatol 2021; 61:1175-1186. [PMID: 34530487 DOI: 10.1111/ijd.15910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/28/2021] [Indexed: 12/12/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic, suppurative condition of the pilosebaceous unit. Patients suffering from HS demonstrate a molecular profile in keeping with a state of systemic inflammation and are often found to fit the criteria for a diagnosis of metabolic syndrome (MetS). In this paper, we review the literature with regards to established data on the prevalence of MetS in HS patients and revise the odds ratio of comorbid disease. Furthermore, we attempt to draw parallels between inflammatory pathways in HS and MetS and evaluate how convergences may explain the risk of comorbid disease, necessitating the need for multidisciplinary care.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta.,European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany.,Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Farida Benhadou
- European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany.,Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Nikolai P Pace
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - John W Frew
- Department of Dermatology, Liverpool Hospital, University of New South Wales, Sydney, NSW, Australia
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26
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Mintoff D, Chatterjee M, Podder I, Shipman A, Das A. Clinical Dermatology and COVID-19 Pandemic: Narrative Review. Indian J Dermatol 2021; 66:246-255. [PMID: 34446947 PMCID: PMC8375546 DOI: 10.4103/ijd.ijd_463_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The coronavirus disease of 2019 (COVID-19) pandemic has radical repercussions on every aspect of medical science, including dermatology. The magnitude of the impact on clinical dermatology cannot be overemphasized. Dermatologists have been forced to modify and reconsider the way they consult patients. Teledermatology has come up in a big way, with most of the clinicians resorting to technology and software-based consultations. Management of different dermatological conditions like papulosquamous disorders, vesiculobullous disorders, malignancies, etc., needs to be modified as per the different recommendations proposed by expert panels. This review is an attempt to highlight the impact of this destructive pandemic on various aspects of clinical dermatology.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | | | - Indrashis Podder
- Department of College of Medicine and Sagore Dutta Hospital, India
| | - Alexa Shipman
- Department of Portsmouth Hospitals University NHS Trust, UK
| | - Anupam Das
- Department of KPC Medical College and Hospital, Kolkata, West Bengal, India
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27
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Affiliation(s)
- D Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Pisani
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - A Betts
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - L Scerri
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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28
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Mintoff D, Pace NP, Bauer P, Borg I. A novel c.671_682del NCSTN variant in a family with hidradenitis suppurativa: a pilot study. Clin Exp Dermatol 2021; 46:1306-1308. [PMID: 33852739 DOI: 10.1111/ced.14677] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/26/2022]
Affiliation(s)
- D Mintoff
- Department of Dermatology, Mater Dei Hospital, Malta
| | - N P Pace
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, Malta.,Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Malta
| | - P Bauer
- CENTOGENE GmbH, Rostock, Germany
| | - I Borg
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, Malta.,Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Malta.,Medical Genetics Unit, Department of Pathology, Mater Dei Hospital, Malta
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29
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Mintoff D, Borg I, Vornweg J, Mercieca L, Merdzanic R, Numrich J, Aquilina S, Pace NP, Fischer J. A novel SPINK5 donor splice site variant in a child with Netherton syndrome. Mol Genet Genomic Med 2021; 9:e1611. [PMID: 33534181 PMCID: PMC8104165 DOI: 10.1002/mgg3.1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Netherton syndrome (NS) is a genodermatosis caused by loss-of-function mutations in SPINK5, resulting in aberrant LEKTI expression. METHOD Next-generation sequencing of SPINK5 (NM_001127698.1) was carried out and functional studies were performed by immunofluorescence microscopy of a lesional skin biopsy using anti-LEKTI antibodies. RESULTS We describe a novel SPINK5 likely pathogenic donor splice site variant (NM_001127698.1:c.2015+5G>A) in a patient with NS and confirm its functional significance by demonstrating complete loss of LEKTI expression in lesional skin by immunofluorescence analysis. CONCLUSION The 2015+5G>A is a novel, likely pathogenic variant in NS. Herein we review and assimilate documented SPINK5 pathogenic variants and discuss possible genotype-phenotype associations in NS.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Isabella Borg
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Medical Genetics Unit, Department of Pathology, Mater Dei Hospital, Msida, Malta.,Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Julia Vornweg
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Liam Mercieca
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | | | | | - Susan Aquilina
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - Nikolai Paul Pace
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Judith Fischer
- Institute of Human Genetics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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30
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Mintoff D, Betts A, Aquilina S. Papillomatosis cutis lymphostatica and 'Ski-Jump' nails. Pediatr Dermatol 2021; 38:332-333. [PMID: 33210394 DOI: 10.1111/pde.14457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/26/2020] [Accepted: 10/24/2020] [Indexed: 11/28/2022]
Abstract
Papillomatosis cutis lymphostatica is an uncommon condition usually associated with lymphedema. "Ski-jump" nails are upward sloping concave nails that can be an important diagnostic sign which may be overlooked in the setting of lymphedema. A diagnosis of papillomatosis cutis lymphostatica should be suspected in patients presenting with persistent, bland papilliform plaques, supported by the additional presence of "ski-jump" nails.
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Affiliation(s)
- Dillon Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | | | - Susan Aquilina
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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31
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Mintoff D, Pace NP, Mercieca V, Bauer P, Borg I. A novel c.916C>A EDA gene pathogenic variant in a boy with X-linked hypohidrotic ectodermal dysplasia. Clin Exp Dermatol 2020; 46:618-620. [PMID: 33222196 DOI: 10.1111/ced.14522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Affiliation(s)
- D Mintoff
- Department of Dermatology and Venereology, Mater Dei Hospital, Malta
| | - N P Pace
- Centre for Molecular Medicine and Biobanking, University of Malta, Malta
| | - V Mercieca
- Department of Paediatrics, Gozo General Hospital, Victoria, Gozo, Malta
| | - P Bauer
- CENTOGENE AG, Rostock, Germany
| | - I Borg
- Centre for Molecular Medicine and Biobanking, University of Malta, Malta.,Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Malta.,Medical Genetics Unit, Department of Pathology, Mater Dei Hospital, Malta
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32
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Mintoff D, Camilleri L, Aquilina S, Boffa MJ, Clark E, Scerri L. Prevalence of hidradenitis suppurativa in Malta: comparison with established epidemiological data. Clin Exp Dermatol 2020; 45:758-759. [PMID: 32367586 DOI: 10.1111/ced.14271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2020] [Indexed: 01/02/2023]
Affiliation(s)
- D Mintoff
- Department of Dermatology and Venereology, Sir Paul Boffa Hospital, Floriana, Malta
| | - L Camilleri
- Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | - S Aquilina
- Department of Dermatology and Venereology, Sir Paul Boffa Hospital, Floriana, Malta
| | - M J Boffa
- Department of Dermatology and Venereology, Sir Paul Boffa Hospital, Floriana, Malta
| | - E Clark
- Department of Dermatology and Venereology, Sir Paul Boffa Hospital, Floriana, Malta
| | - L Scerri
- Department of Dermatology and Venereology, Sir Paul Boffa Hospital, Floriana, Malta
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33
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Mintoff D, Betts A, Scerri L. Misleading dermoscopic findings in an epidermal cyst. J Eur Acad Dermatol Venereol 2020; 34:e339-e340. [PMID: 32103559 DOI: 10.1111/jdv.16316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D Mintoff
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
| | - A Betts
- Department of Pathology, Mater Dei Hospital, Swatar, Malta
| | - L Scerri
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
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34
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Mintoff D, Betts A, Boffa MJ. Influenza vaccine‐associated cutaneous lupus erythematosus. Clin Exp Dermatol 2019; 45:450-452. [DOI: 10.1111/ced.14130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/19/2019] [Accepted: 10/22/2019] [Indexed: 11/29/2022]
Affiliation(s)
- D. Mintoff
- Department of Dermatology Sir Paul Boffa Hospital Floriana Malta
| | - A. Betts
- Department of Pathology Mater Dei Hospital Msida Malta
| | - M. J. Boffa
- Department of Dermatology Sir Paul Boffa Hospital Floriana Malta
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35
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Galdes C, Mintoff D, Clark E. Gorlin-Goltz Syndrome: A Rare Syndrome Presenting as an Even Rarer de Novo Case with Numerous Features and Complications. Skinmed 2019; 17:324-327. [PMID: 31782707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 76-year-old woman with intellectual deficit presented with a small, pearly, telangiectatic raised lesion on the left cheek, together with an ulcerated lesion on the right side of the nose (Figure 1), which were clinically diagnosed as basal cell carcinomas (BCCs.) These were treated with cryotherapy. The patient had had a right hemimandibulectomy (Figure 1), and she showed frontal and temporal bossing and a wide nasal bridge.
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Affiliation(s)
| | - Dillon Mintoff
- Department of Dermatology, Sir Paul Boffa Hospital, Malta
| | - Eileen Clark
- Department of Dermatology, Sir Paul Boffa Hospital, Malta;
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36
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Benhadou F, Van der Zee H, Pascual J, Rigopoulos D, Katoulis A, Liakou A, Daxhelet M, Romanelli M, Iannone M, Kinyó Á, Nikolakis G, Zouboulis C, Dessinioti C, Zisimou C, Antoniou C, Alavi A, Mintoff D, Aquilina S, Matusiak L, Szepietowski J, Sinclair R, Husein‐ElAhmed H, von Laffert M, Revuz J, Danby B, Puig L, Theut Riis P, Jemec G, Straalen K, Wigny K, Marmol V, Guillem P. Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross‐sectional study among 2465 patients. Br J Dermatol 2019; 181:1198-1206. [DOI: 10.1111/bjd.17927] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2019] [Indexed: 12/14/2022]
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37
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Zouboulis CC, Matusiak Ł, Jemec GBE, Szepietowski JC, Álvarez-Chinchilla PJ, Asoskova A, Bonnekoh H, Brattoli G, Cetinarslan TS, Dawicka J, Dente V, Gallyamova Y, Giovanardi G, Glasenhardt K, Ionescu AM, Janushaj E, Lakhssassi MK, Lőrincz KK, Ludew D, Makmatov-Rys M, Malickova M, Mengesha SW, Mintoff D, Otlewska A, Papakou M, Pirvan AM, Provvidenziale L, Quadrana F, Savickaja N, Tamulyté G, Trifu A, Vīgante A, Włodarek K, Zouboulis VA. Inter-rater and intrarater agreement and reliability in clinical staging of hidradenitis suppurativa/acne inversa. Br J Dermatol 2019; 181:852-854. [PMID: 30968946 DOI: 10.1111/bjd.17982] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany.,European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - Ł Matusiak
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - G B E Jemec
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Zealand University Hospital, Roskilde; Health Sciences Faculty, University of Copenhagen, Denmark
| | - J C Szepietowski
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | | | | | | | | | | | | | - K Glasenhardt
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | | | | | | | | | | | | | | | - S W Mengesha
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - D Mintoff
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | - A Otlewska
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | | | - N Savickaja
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany
| | | | | | | | - K Włodarek
- European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.,Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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38
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Benhadou F, Mintoff D, Del Marmol V. Psoriasis: Keratinocytes or Immune Cells - Which Is the Trigger? Dermatology 2018; 235:91-100. [PMID: 30566935 DOI: 10.1159/000495291] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/12/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psoriasis is a common, chronic inflammatory skin disorder, which can significantly impact quality of life. Despite major breakthroughs in our understanding of the pathogenesis of psoriasis, the chronological order of the underlying mechanisms leading to the development of psoriatic plaques remains to be completely understood. SUMMARY Although psoriasis is classically perceived as a T-cell disease, it is now well recognized that T lymphocytes do not function in exclusivity. This theory is supported by evidence from transgenic murine models that develop marked psoriasiform disease. In addition, immune cells and cytokines regulate both early and late events involved in the pathogenesis of psoriasis. Key Messages: Psoriasis is a complex disease - a dynamic interplay between immune cells, keratinocytes, and various other skin-resident cells, such as endothelial and immune cells. The contribution of each cell type is crucial in the initiation and maintenance phases of psoriatic alterations.
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Affiliation(s)
- Farida Benhadou
- Dermatology Department, Erasme Hospital, Université Libre de Bruxelles - ULB, Brussels, Belgium, .,Laboratory of Stem Cells and Cancer, Unversité Libre de Bruxelles - ULB, Brussels, Belgium,
| | - Dillon Mintoff
- Dermatology Department, Sir Paul Boffa Hospital, Floriana, Malta
| | - Véronique Del Marmol
- Dermatology Department, Erasme Hospital, Université Libre de Bruxelles - ULB, Brussels, Belgium
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39
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Benhadou F, Mintoff D, Schnebert B, Thio HB. Psoriasis and Microbiota: A Systematic Review. Diseases 2018; 6:diseases6020047. [PMID: 29865237 PMCID: PMC6023392 DOI: 10.3390/diseases6020047] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 05/29/2018] [Accepted: 06/01/2018] [Indexed: 12/21/2022] Open
Abstract
Background: Recent advances have highlighted the crucial role of microbiota in the pathophysiology of chronic inflammatory diseases as well as its impact on the efficacy of therapeutic agents. Psoriasis is a chronic, multifactorial inflammatory skin disorder, which has a microbiota distinct from healthy, unaffected skin. Aim: Through an extensive review of the literature, we aim to discuss the skin and gut microbiota and redefine their role in the pathogenesis of psoriasis. Conclusions: Unfortunately, the direct link between the skin microbiota and the pathogenesis of psoriasis remains to be clearly established. Apart from improving the course of psoriasis, selective modulation of the microbiota may increase the efficacy of medical treatments as well as attenuate their side effects.
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Affiliation(s)
- Farida Benhadou
- Dermatology Department, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, Anderlecht, 1070 Brussels, Belgium.
| | - Dillon Mintoff
- Dermatology Department, Sir Paul Boffa Hospital, 1491 Floriana, Malta.
| | - Benjamin Schnebert
- Medecine Faculty, Université Libre de Bruxelles, 1070 Brussels, Belgium.
| | - Hok Bing Thio
- Dermatology Department, Erasmus Medical Center, 3000 Rotterdam, The Netherlands.
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40
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Magri CJ, Mintoff D, Camilleri L, Xuereb RG, Galea J, Fava S. Relationship of Hyperglycaemia, Hypoglycaemia, and Glucose Variability to Atherosclerotic Disease in Type 2 Diabetes. J Diabetes Res 2018; 2018:7464320. [PMID: 30140707 PMCID: PMC6081537 DOI: 10.1155/2018/7464320] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/01/2018] [Accepted: 06/24/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is known to be associated with increased cardiovascular risk. The aim of this study was therefore to investigate the independent effects of hyperglycaemia, hypoglycaemia, and glucose variability on microvascular and macrovascular disease in T2DM. METHODS Subjects with T2DM of <10 years duration and on stable antiglycaemic treatment underwent carotid intima-media thickness (CIMT), ankle-brachial index (ABI), albumin-creatinine ratio (ACR), and HbA1c measurement, as well as 72-hour continuous glucose monitoring. Macrovascular disease was defined as one or more of the following: history of ischaemic heart disease (IHD), cerebrovascular accident (CVA), ABI < 0.9, or abnormal CIMT. RESULTS The study population comprised 121 subjects with T2DM (89 males : 32 females). The mean age was 62.6 years, and the mean DM duration was 3.7 years. Macrovascular disease was present in 71 patients (58.7%). In multivariate logistic regression analysis, body surface area (BSA) (OR 18.88 (95% CI 2.20-156.69), p = 0.006) and duration of blood glucose (BG) < 3.9 mmol/L (OR 1.12 (95% CI 1.014-1.228), p = 0.024) were independent predictors of macrovascular disease. BSA (OR 12.6 (95% CI 1.70-93.54), p = 0.013) and duration of BG < 3.9 mmol/L (OR 1.09 (95% CI 1.003-1.187), p = 0.041) were independent predictors of abnormal CIMT. Area under the curve for BG > 7.8 mmol/L (β = 15.83, p = 0.005) was the sole independent predictor of albuminuria in generalised linear regression. CONCLUSIONS This study demonstrates that hypoglycaemia is associated with the occurrence of atherosclerotic disease while hyperglycaemia is associated with microvascular disease in a Caucasian population with T2DM of recent duration.
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Affiliation(s)
- Caroline Jane Magri
- Department of Cardiology, Mater Dei Hospital and University of Malta, Msida, Malta
- Department of Cardiology, Mater Dei Hospital, Msida, Malta
| | | | - Liberato Camilleri
- Statistics & Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | | | - Joseph Galea
- Mater Dei Hospital and University of Malta, Msida, Malta
| | - Stephen Fava
- Mater Dei Hospital and University of Malta, Msida, Malta
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41
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Magri CJ, Mintoff D, Xuereb S, Xuereb RG. An unusual cause of hemiplegia post-percutaneous coronary intervention. Br J Hosp Med (Lond) 2016; 77:660. [PMID: 27828736 DOI: 10.12968/hmed.2016.77.11.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Caroline J Magri
- Resident Specialist in the Department of Cardiology, Mater Dei Hospital, Msida MSD 2090, Malta and Visiting Lecturer, University of Malta, Malta
| | - Dillon Mintoff
- Foundation Year 2 Doctor in the Department of Cardiology, Mater Dei Hospital, Malta
| | - Sara Xuereb
- Foundation Year 2 Doctor in the Department of Cardiology, Mater Dei Hospital, Malta
| | - Robert G Xuereb
- Chairman and Consultant Cardiologist in the Department of Cardiology, Mater Dei Hospital, and Visiting Senior Lecturer, University of Malta, Malta
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