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Yamanaka-Takaichi M, Alavi A. Palisaded Neutrophilic Granulomatous Dermatitis, Bowel-Associated Dermatosis-Arthritis Syndrome, and Rheumatoid Neutrophilic Dermatitis. Dermatol Clin 2024; 42:297-305. [PMID: 38423688 DOI: 10.1016/j.det.2023.08.008] [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] [Indexed: 03/02/2024]
Abstract
Neutrophilic dermatosis is a heterogeneous group of inflammatory skin diseases characterized by the presence of a sterile neutrophilic infiltrate on histopathology. Three specific types of neutrophilic dermatoses are reviewed in this article: palisaded neutrophilic granulomatous dermatitis, bowel-associated dermatosis-arthritis syndrome, and rheumatoid neutrophilic dermatitis. The authors review the literature and highlight the clinical and histopathological features, disease pathogenesis, and the association of these conditions with various systemic diseases such as rheumatoid arthritis, inflammatory bowel disease, and others. A multidisciplinary approach is necessary for the diagnosis and management of these inflammatory skin conditions.
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Affiliation(s)
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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2
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Yamanaka-Takaichi M, Demer AM, Baum CL, Theoharides TC, Alavi A. The role of mast cells and related molecules in itch of hidradenitis suppurativa. Exp Dermatol 2024; 33:e15061. [PMID: 38532563 DOI: 10.1111/exd.15061] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/06/2024] [Accepted: 03/10/2024] [Indexed: 03/28/2024]
Affiliation(s)
| | - Addison M Demer
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Christian L Baum
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Theoharis C Theoharides
- Institute of Neuro-Immune Medicine, Nova Southeastern University, Clearwater, Florida, USA
- Department of Immunology, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
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3
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Yamanaka-Takaichi M, Revankar R, Shih T, Gall M, Hsiao JL, Shi VY, Alavi A. Expert consensus on priority research gaps in dietary and lifestyle factors in hidradenitis suppurativa: a Delphi consensus study. Arch Dermatol Res 2023; 315:2129-2136. [PMID: 36951970 DOI: 10.1007/s00403-023-02610-9] [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: 12/09/2022] [Revised: 01/27/2023] [Accepted: 03/14/2023] [Indexed: 03/24/2023]
Abstract
Hidradenitis suppurativa (HS) is a debilitating systemic inflammatory disease with limited treatment options. Although management through dietary and lifestyle changes is a primary interest of the HS patient community, there is lack of consensus regarding recommendations due to the paucity of evidence. To establish the priority research gaps on this topic, we performed and moderated a Delphi consensus study by integrating expert opinions and the relevant literature. Based on a literature review, research questions on dietary and lifestyle interventions in HS were constructed. HS dietary and lifestyle research questions were sent to an expert panel, consisting of 22 international members, including dermatologists, dietitians, pharmacists, and endocrinologists. Voting on the research questions was conducted using a modified Delphi technique. The primary outcome measure was whether participants could reach consensus on the priority of each research question in the HS dietary and lifestyle factors. After three rounds of surveys investigating the relationships between HS and various diet and lifestyle factors, "BMI", "Obesity", and "Smoking", reached consensus as high priority research questions. Low research priorities per consensus included "effects of iron supplements", "effects of magnesium supplements", "alcohol consumption" and "limiting Brewer's yeast intake. Smoking and obesity were identified as important research questions, concurrent to the literature indicating their association with more significant impact on disease activity. By shedding light on high priority research questions, our study provides a roadmap for further research on dietary and lifestyle modifications in HS and will help determine evidence-based lifestyle and dietary recommendations for patients with HS.
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Affiliation(s)
| | - Rishab Revankar
- The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Terri Shih
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | | | - Jennifer L Hsiao
- Department of Dermatology, University of Southern California, Los Angeles, CA, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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Yamanaka-Takaichi M, Raffals LE, Ehman EC, Loftus EV, Alavi A. Anemia and Systemic Inflammatory Markers in Patients with Perianal Disease: Hidradenitis Suppurativa and Inflammatory Bowel Disease. Dermatology 2023; 239:843-848. [PMID: 37356426 DOI: 10.1159/000531653] [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: 03/08/2023] [Accepted: 06/08/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) and inflammatory bowel disease (IBD) have been reported to have a wide variety of overlaps in their pathogenesis, laboratory findings, and histopathology. These two diseases can form draining tunnels and are difficult to differentiate, particularly from fistulizing lesions in the perianal area. OBJECTIVE This retrospective study of HS and IBD patients with perianal lesions sought to analyze the anemia and systemic inflammation biomarkers in these disease groups. METHODS A retrospective chart review was conducted on the laboratory findings of a total of 212 patients with perianal disease - 72 with HS, 78 with IBD, and 62 with both HS and IBD - who were evaluated at Mayo Clinic between 1998 and 2021. RESULTS In the HS group, 45.8% of males and females were anemic, compared to 58.1% of males and 73.5% of females in the IBD group. The HS + IBD group had the highest prevalence of anemia and the lowest hemoglobin levels. The odds ratio for being anemic was 2.19 for the IBD group and 4.05 for the IBD + HS group compared to the HS group. Monocyte/lymphocyte ratio (MLR) and platelet/lymphocyte ratio (PLR) were significantly higher in the IBD group, whereas neutrophil/lymphocyte ratio (NLR) was significantly higher in the IBD + HS group. CONCLUSION Our data show for the first time the prevalence of anemia in patients with HS and IBD who have perianal lesions. In addition, noninvasive biomarkers using complete blood counts such as MLR, PLR, and NLR could be useful not only in differentiating perianal HS from fistulizing perianal IBD but also in selecting treatment.
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Affiliation(s)
| | - Laura E Raffals
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Eric C Ehman
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Edward V Loftus
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
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Alavi A, Anand N, Yamanaka-Takaichi M, Piguet V, Simmers J, Machado M, Todd A, Kirby J. Evaluating the hidradenitis odor and drainage scale (HODS): A new validated potential instrument to assess odor and drainage in hidradenitis suppurativa-A cross-sectional study. JAAD Int 2022; 10:75-76. [PMID: 36688101 PMCID: PMC9850199 DOI: 10.1016/j.jdin.2022.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota,Correspondence and reprint requests to: Afsaneh Alavi, MD, Department of Dermatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902
| | - Nimay Anand
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | | | - Vincent Piguet
- Division of Dermatology, Department of Medicine, Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jocelyn Simmers
- Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Philadelphia
| | - Myrela Machado
- Division of Dermatology, Department of Medicine, Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Austin Todd
- Department of Clinical Trials & Biostatistics, Mayo Clinic, Rochester, Minnesota
| | - Joslyn Kirby
- Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Philadelphia
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Yamanaka-Takaichi M, Ghanian S, Katzka DA, Torgerson RR, Alavi A. Candida Infection Associated with Anti-IL-17 Medication: A Systematic Analysis and Review of the Literature. Am J Clin Dermatol 2022; 23:469-480. [PMID: 35428934 DOI: 10.1007/s40257-022-00686-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/25/2022]
Abstract
Anti-interleukin (IL)-17 agents have shown excellent therapeutic efficacy in patients with psoriasis and are expected to be expanded to other chronic inflammatory diseases. However, patients receiving anti-IL-17 agents are at an increased risk of developing Candida infection, with some agents reported to increase the incidence in a dose-dependent manner. Interleukin-17 is secreted by the Th17 subset of CD4+ lymphocytes, CD8+ T cells, and innate cells, including natural killer T cells, lymphoid tissue inducer cells, innate lymphoid cells, and γδ-T cells, and plays an important role in antifungal defense. Genetic defects in the IL-17-signaling pathway in both humans and animal models render susceptibility to candidiasis caused by Candida albicans. The purpose of this narrative review is to evaluate the literature on the role of IL-17 in protection against candidiasis, the prevalence of candidiasis in anti-IL-17 agent use, and to offer clinical recommendations on the diagnosis and management of anti-IL-17 medication-associated candidiasis.
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Affiliation(s)
| | - Soha Ghanian
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - David A Katzka
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | | | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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Ghanian S, Yamanaka-Takaichi M, Naik HB, Alavi A. Medical Management of Hidradenitis Suppurativa with Non-Biologic Therapy: What's New? Am J Clin Dermatol 2022; 23:167-176. [PMID: 34990004 DOI: 10.1007/s40257-021-00667-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 11/25/2022]
Abstract
Hidradenitis suppurativa (HS) is a severe chronic relapsing inflammatory disorder of the hair follicle unit that can cause painful abscesses, nodules, tunnels, and tracts in intertriginous parts of the body. The disease can often result in disfigurement and adversely impact patient quality of life. The management of HS has expanded significantly over the past decade to include multiple modalities, including topical therapies, systemic therapies (non-biologics and biologics), surgical therapies, lifestyle changes, and management of comorbidities. Management can often be clinically challenging and may involve the combination of medical and surgical approaches for optimal results. The purpose of this review is to present an update on non-biologic and non-interventional modalities published in 2019-2021 in the clinical management of HS. With emerging therapies, ongoing clinical trials, and heightened awareness about HS, there is hope that new treatment options will revolutionize the management of patients suffering from HS.
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Affiliation(s)
- Soha Ghanian
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Haley B Naik
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
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Kusutani N, Yamanaka-Takaichi M, Yanagishita-Nakatsuji S, Kadoya M, Hasegawa I, Tsutada T, Shimizu J, Ohe S, Isei T, Itoh Y, Fukai K, Tateishi C, Tsuruta D. Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase antibody-positive myopathy associated with advanced stage of cutaneous squamous cell carcinoma. Australas J Dermatol 2021; 62:e460-e462. [PMID: 34028804 DOI: 10.1111/ajd.13619] [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)
- Nao Kusutani
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Dermatology, Osaka City General Hospital, Osaka, Japan
| | - Mika Yamanaka-Takaichi
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Masato Kadoya
- Division of Neurology, Department of Internal Medicine, National Defense Medical College, Saitama, Japan
| | - Itsuki Hasegawa
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tsuyoshi Tsutada
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Jun Shimizu
- Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,Department of Physical Therapy, Tokyo University of Technology, Tokyo, Japan
| | - Shuichi Ohe
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Taiki Isei
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoshiaki Itoh
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kazuyoshi Fukai
- Department of Dermatology, Osaka City General Hospital, Osaka, Japan
| | - Chiharu Tateishi
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Yamanaka-Takaichi M, Sugawara K, Sumitomo R, Tsuruta D. The Mast Cell-SCF-CB1 Interaction Is a Key Player in Seborrheic Keratosis. J Histochem Cytochem 2020; 68:461-471. [PMID: 32578480 DOI: 10.1369/0022155420938031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mast cell (MC) is an important player in the development of skin diseases, including atopic dermatitis, psoriasis, and urticaria. It is reported that MC infiltration and activation are observed around various types of tumors and speculated that MCs play key roles in their pathogenesis. As MCs in human seborrheic keratosis (SK) have not been well investigated, here we focused on the MCs in SK. The number of c-Kit and tryptase-positive MCs was significantly increased around the SK compared with the marginal lesion. Degranulated MCs were also increased around the tumors. Furthermore, MC growth factor, stem cell factor (SCF), expression within the SK was significantly upregulated compared with the marginal lesion. Interestingly, one of the cognitive regulators of SCF expression, cannabinoid receptor type 1 (CB1) immunoreactivity was downregulated within the SK. Our results suggest that MCs play important roles in the pathogenesis of SK and that SCF can be also deeply involved in the development of SKs. Our current results highlight the CB1-SCF-MC interaction as a novel mechanism of SK development and this also will be utilized for developing a novel treatment.
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Affiliation(s)
- Mika Yamanaka-Takaichi
- Department of Dermatology, Graduate School of Medicine, Osaka City University, Osaka, Japan (MY-T, KS, RS, DT)
| | - Koji Sugawara
- Department of Dermatology, Graduate School of Medicine, Osaka City University, Osaka, Japan (MY-T, KS, RS, DT)
| | - Rieko Sumitomo
- Department of Dermatology, Graduate School of Medicine, Osaka City University, Osaka, Japan (MY-T, KS, RS, DT)
| | - Daisuke Tsuruta
- Department of Dermatology, Graduate School of Medicine, Osaka City University, Osaka, Japan (MY-T, KS, RS, DT)
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Yamanaka-Takaichi M, Ozawa T, Kusutani N, Sowa-Osako J, Tanaka M, Murata Y, Kubo Y, Ohsawa M, Tsuruta D, Sakai H. Relationship between dermoscopy and pathology in a case of clonal-type pigmented Bowen's disease: Observation with vertical-view dermoscopy. J Dermatol 2019; 46:436-439. [PMID: 30768803 DOI: 10.1111/1346-8138.14814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/14/2018] [Accepted: 01/15/2019] [Indexed: 11/28/2022]
Abstract
Pigmented Bowen's disease (pBD) is a subtype of Bowen's disease, which presents clinically as a well-circumscribed, hyperpigmented plaque. Its clinical manifestations are not fully characterized, and differential diagnoses include various pigmented skin lesions. Dermoscopy could be useful for the diagnosis, although nothing has been reported on the dermoscopic features of clonal-type pBD. We herein report a first case of clonal-type pBD on the sole and its dermoscopic features. Dermoscopy showed brown to blue-gray dots/globules and focally anastomosing lines on the non-weight-bearing area, while the weight-bearing area had a brown to blue-gray fibrillar-like pattern. To investigate the relationship between dermoscopy and histopathology, we focused on the melanin distribution in the horny layer of the epidermis, and used vertical dermoscopy observation. We investigated the relationship between dermoscopy and pathology by melanin depth estimation using a color lightness value.
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Affiliation(s)
- Mika Yamanaka-Takaichi
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Toshiyuki Ozawa
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Nao Kusutani
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Junko Sowa-Osako
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masaru Tanaka
- Department of Dermatology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Yozo Murata
- Department of Dermatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuki Kubo
- Department of Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masahiko Ohsawa
- Department of Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Daisuke Tsuruta
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Sakai
- Department of Dermatology, Osaka Police Hospital, Osaka, Japan
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