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Hegazy EM, Taieb MAE, Hassan MH, Ibrahim AK, El-Din EA, Ibrahim HM. Plexin B2 tissue expression and related gene polymorphisms in psoriasis and their relation to NB-UVB and Acitretin therapy. Arch Dermatol Res 2024; 316:162. [PMID: 38734848 DOI: 10.1007/s00403-024-02880-x] [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: 10/23/2023] [Revised: 11/13/2023] [Accepted: 04/14/2024] [Indexed: 05/13/2024]
Abstract
Psoriasis is a chronic, immune-mediated, hyperproliferative skin disease. Etiopathogenesis of psoriasis is not well understood. Plexin B2 was found to have effects on CD100-mediated T-cell morphology and expressed in the immune system. It may play a role in the pathogenesis of psoriasis. To assess the tissue level of plexin-B2 and plexin B2 related gene polymorphism which is signal regulatory protein gamma (SIRPγ-rs71212732) in psoriatic patients before and after NB-UVB, acitretin therapy alone or in combination and to detect correlation between level of tissue plexin B2 and disease severity and improvement. This single blinded randomized controlled trial was carried on 50 psoriatic patients and 50 healthy controls. Psoriasis Area and Severity Index score (PASI) was used to evaluate the disease severity. Tissue plexin-b2 level was measured using ELISA and SIRPγ-rs71212732 (T\C) was assessed using TaqMan™ assays and real-time PCR. A significant lower tissue plexin-B2 level was observed in control group (2.9 ± 0.6 pg/g) than cases (25.8 ± 2.8, pg/g) (p < 0.001). Also, a significantly higher tissue plexin-B2 level was observed in sever psoriasis (32.7 ± 3.8 pg/ml) in than moderate psoriasis (13.6 ± 2.1 pg/ml, p = 0.001). Tissue plexin B2 was positively correlated with diseases severity. Significantly higher (TC& TT) genotypes and mutant (C) allele among patients compared to the controls, p < 0.001 for all. Tissue plexin-b2 level was high in psoriasis vulgaris with positive correlation with disease severity and decreased after treatment. This may indicate a role of plexin-b2 in psoriasis vulgaris pathogenesis.
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Affiliation(s)
- Eisa Mohamed Hegazy
- Dermatology, Venereology and Andrology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt.
| | - Moustafa A El Taieb
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Mohammed H Hassan
- Medical Biochemistry Department, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ahmed K Ibrahim
- Community Medicine Department, Asuit University, Asuit, Egypt
| | - Ebtehal A El-Din
- Dermatology, Venereology and Andrology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Hassan M Ibrahim
- Dermatology, Venereology and Andrology Department, Qena Faculty of Medicine, South Valley University, Qena, Egypt
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Kovacheva K, Kamburova Z, Vasilev P, Yordanova I. Netherton Syndrome with a Novel Likely Pathogenic Variant c.420del (p.Ser141ProfsTer5) in SPINK5 Gene: A Case Report. Case Rep Dermatol 2024; 16:47. [PMID: 38406644 PMCID: PMC10890808 DOI: 10.1159/000536083] [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: 08/23/2023] [Accepted: 01/01/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction Netherton syndrome (NS) is a rare autosomal recessive genodermatosis in the group of congenital ichthyosis. The clinical manifestations of the syndrome vary from a very mild clinical manifestation occurring with the picture of ichthyosis linearis circumflexa to exfoliative erythroderma. It can be fatal in the first days of a newborn's life due to dehydration, hypothermia, weight loss, respiratory infections, and sepsis. A specific anomaly of the hair trichorrexis invaginata is considered pathognomonic for the syndrome. Genetic testing of SPINK5 gene is key to confirming the diagnosis and starting early treatment. Case Presentation We present a case report of NS in a 6-year-old boy who suffered from generalized erythroderma and desquamation of the skin from birth. The patient has atopic diathesis, recurrent skin infections, increased levels of IgE, and delayed physical development. Two genetic variants in SPINK5 gene with clinical significance were identified. The first detected variant is a nonsense mutation, predicted to cause loss of normal protein function either by protein truncation or by nonsense-mediated mRNA decay. The second variant is a likely pathogenic frameshift mutation that truncates the protein in 5 amino acids. The child was treated with acitretin, without satisfactory effect. Conclusion The genetic variant we have described correlates with a severe clinical phenotype of NS. The second genetic variant of the SPINK5 gene, inherited from the father in our case, is novel and has never been published in the literature.
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Affiliation(s)
- Katya Kovacheva
- Department of Medical Genetics, Faculty of Pharmacy, Medical University, Pleven, Bulgaria
| | - Zornitza Kamburova
- Department of Medical Genetics, Faculty of Pharmacy, Medical University, Pleven, Bulgaria
| | - Preslav Vasilev
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University, Pleven, Bulgaria
| | - Ivelina Yordanova
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University, Pleven, Bulgaria
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Bansal A, Singla A, Paul D, Kaur S. Pembrolizumab-Induced Lichen Planus: A Rare Immune-Related Adverse Side Effect. Indian Dermatol Online J 2023; 14:391-394. [PMID: 37266094 PMCID: PMC10231724 DOI: 10.4103/idoj.idoj_377_22] [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: 07/07/2022] [Revised: 11/02/2022] [Accepted: 12/11/2022] [Indexed: 06/03/2023] Open
Abstract
Pembrolizumab is the first anti-programmed death protein-1 agent approved by the US Food and Drug Administration. It has demonstrated efficacy in melanoma, lung cancer, and other advanced solid tumours and hematologic malignancies. Various dermatological side effects including pruritus, maculopapular rash, vitiligo, lichenoid skin reactions, psoriasis, and rarely life-threatening conditions like bullous pemphigoid, Stevens-Johnson syndrome, and drug rash with eosinophilia and systemic symptoms have been reported. We report a case of pembrolizumab-induced lichen planus in a 54-year-old female who was receiving pembrolizumab for management of lung metastasis from squamous cell carcinoma of the buccal mucosa. The lichen planus responded to acitretin and pembrolizumab was continued safely.
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Affiliation(s)
- Aditi Bansal
- Department of Dermatology, Venereology and Leprology, Deep Hospital, Ludhiana, Punjab, India
| | - Ankur Singla
- Department of Dermatology, Venereology and Leprology, Ludhiana, Punjab, India
| | - Davinder Paul
- Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sukhjot Kaur
- Department of Dermatology, Venereology and Leprology, Ludhiana, Punjab, India
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Spencer RK, Jin JQ, Elhage KG, Davis MS, Hakimi M, Bhutani T, Liao W. Comparative efficacy of biologics and oral agents in palmoplantar psoriasis and palmoplantar pustulosis: A systematic review and network meta-analysis of randomized clinical trials. J Am Acad Dermatol 2023:S0190-9622(23)00746-6. [PMID: 37121476 DOI: 10.1016/j.jaad.2023.04.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Riley K Spencer
- Department of Dermatology, University of California San Francisco, San Francisco, CA; Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ
| | - Joy Q Jin
- Department of Dermatology, University of California San Francisco, San Francisco, CA; School of Medicine, University of California San Francisco, San Francisco, CA
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, CA.
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Cai A, Liu N, Lin Z, Li X, Wang J, Wu Y, Gao K, Jiang Y. In Vitro Effects of Acitretin on Human Neuronal SH-SY5Y Cells. Neurochem Res 2023; 48:72-81. [PMID: 35987975 PMCID: PMC9822877 DOI: 10.1007/s11064-022-03716-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 07/07/2022] [Accepted: 07/30/2022] [Indexed: 01/11/2023]
Abstract
Acitretin is an oral drug approved by the Food and Drug Administration that is commonly used to treat psoriasis. In recent years, acitretin has been identified as a candidate drug for the treatment of Alzheimer's disease, but its role in neuronal development is still unclear. In this study, the human neuroblastoma cell line SH-SY5Y was used as a model to study neuronal differentiation. We found that acitretin effectively promoted the differentiation of SH-SY5Y cells into neuronal cells and upregulated the expression of the neuronal marker β-III tubulin and the mature neuronal marker NFH. Differentially expressed genes were identified by RNA sequencing and analyzed by bioinformatics approaches. The results showed that genes associated with neuron development-related pathways, such as SSPO and KCNT1, had significant changes in expression. Analysis showed that PRKCA and CAMK2B may play important roles in the process by which acitretin promotes neurodevelopment. Through whole-cell patch clamping and a microelectrode array assay, we found that acitretin-treated neurons generated electrical spikes similar to those generated by mature neurons. This study provided evidence to support an accessible and safe model of neuron-like cells and verified that acitretin can promote the differentiation of neurons and has the potential to treat brain tumors and neurodevelopmental and neurodegenerative diseases.
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Affiliation(s)
- Aojie Cai
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, China
- Children Epilepsy Center, Peking University First Hospital, Beijing, China
| | - Nana Liu
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, China
- Children Epilepsy Center, Peking University First Hospital, Beijing, China
| | - Zehong Lin
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, China
- Children Epilepsy Center, Peking University First Hospital, Beijing, China
| | - Xiao Li
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, China
- Children Epilepsy Center, Peking University First Hospital, Beijing, China
| | - Jingmin Wang
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, China
- Children Epilepsy Center, Peking University First Hospital, Beijing, China
- Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, China
| | - Ye Wu
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, China
- Children Epilepsy Center, Peking University First Hospital, Beijing, China
| | - Kai Gao
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China.
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, China.
- Children Epilepsy Center, Peking University First Hospital, Beijing, China.
- Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, China.
| | - Yuwu Jiang
- Department of Pediatrics, Peking University First Hospital, No.1 Xi'an Men Street, West District, Beijing, 100034, China.
- Beijing Key Laboratory of Molecular Diagnosis and Study on Pediatric Genetic Diseases, Beijing, China.
- Children Epilepsy Center, Peking University First Hospital, Beijing, China.
- Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, China.
- Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing, China.
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Elzayat EM, Shahien SA, El-Sherif AA, Hosney M. miRNAs and Stem Cells as Promising Diagnostic and Therapeutic Targets for Alzheimer's Disease. J Alzheimers Dis 2023; 94:S203-S225. [PMID: 37212107 PMCID: PMC10473110 DOI: 10.3233/jad-221298] [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] [Accepted: 03/30/2023] [Indexed: 05/23/2023]
Abstract
Alzheimer's disease (AD) is a cumulative progressive neurodegenerative disease characterized mainly by impairment in cognitive functions accompanied by memory loss, disturbance in behavior and personality, and difficulties in learning. Although the main causes of AD pathogenesis are not fully understood yet, amyloid-β peptides and tau proteins are supposed to be responsible for AD onset and pathogenesis. Various demographic, genetic, and environmental risk factors are involved in AD onset and pathogenesis such as age, gender, several genes, lipids, malnutrition, and poor diet. Significant changes were observed in microRNA (miRNA) levels between normal and AD cases giving hope for a diagnostic procedure for AD through a simple blood test. As yet, only two classes of AD therapeutic drugs are approved by FDA. They are classified as acetylcholinesterase inhibitors and N-methyl-D-aspartate antagonists (NMDA). Unfortunately, they can only treat the symptoms but cannot cure AD or stop its progression. New therapeutic approaches were developed for AD treatment including acitretin due to its ability to cross blood-brain barrier in the brain of rats and mice and induce the expression of ADAM 10 gene, the α-secretase of human amyloid-β protein precursor, stimulating the non-amyloidogenic pathway for amyloid-β protein precursor processing resulting in amyloid-β reduction. Also stem cells may have a crucial role in AD treatment as they can improve cognitive functions and memory in AD rats through regeneration of damaged neurons. This review spotlights on promising diagnostic techniques such as miRNAs and therapeutic approaches such as acitretin and/or stem cells keeping in consideration AD pathogenesis, stages, symptoms, and risk factors.
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Affiliation(s)
- Emad M. Elzayat
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
| | - Sherif A. Shahien
- Biotechnology/Bimolecular Chemistry Program, Faculty of Science, Helwan University, Cairo, Egypt
| | - Ahmed A. El-Sherif
- Department of Chemistry, Faculty of Science, Cairo University, Giza, Egypt
| | - Mohamed Hosney
- Zoology Department, Faculty of Science, Cairo University, Giza, Egypt
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Zhang L, Zeng Q, Li J, Chen N, Tang H, Lei X, Wu J, Cheng Q. ALA-PDT combined with oral acitretin in the treatment of refractory condyloma acuminatum in anal canal. Photodiagnosis Photodyn Ther 2022; 40:103048. [PMID: 36183481 DOI: 10.1016/j.pdpdt.2022.103048] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Condyloma acuminatum (CA) of the anal canal is difficult to treat and subject to relapse.. We investigated the effects of aminolevulinic acid-based photodynamic therapy (ALA-PDT) combined with oral acitretin during therapy of refractory CA in the anal canal. We also conducted a clinical retrospective study for the treatment of intra-anal CA. METHODS A total of 101 patients diagnosed with intra-anal CA were enrolled. All patients underwent liquid nitrogen cryotherapy as a basic treatment until visible wart clearance. Patients were divided into two groups depending on the treatment modality after cryotherapy. ALA-PDT group with 51 patients was given ALA-PDT treatment, and ALA-PDT plus acitretin group with 50 patients was given ALA-PDT treatment combined with oral acitretin. The cure rate, recurrence rate, and adverse reactions of the two groups were analyzed and recorded. RESULTS The cure rate in the ALA-PDT plus acitretin group was 94% (47/50), which was significantly higher than 80.4% (41/51) in ALA-PDT group. The recurrence rate in the ALA-PDT plus acitretin group was 6% (3/50), which was lower than 19.6% (10/51) in ALA-PDT group (P<0.05). CONCLUSION ALA-PDT combined with oral acitretin is effective and safe in the treatment of refractory CA in anal canal, and with further study may become an option for these patients.
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Affiliation(s)
- Long Zhang
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Qianwen Zeng
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jinzhuo Li
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Nian Chen
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Hui Tang
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jinjin Wu
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China.
| | - Qionghui Cheng
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing 400042, China.
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Rajesh S, Loganathan E, Shanmukhappa AG. Ichthyosis Follicularis with Alopecia and Photophobia Syndrome with Coexisting Palmoplantar Keratoderma Treated with Acitretin. Int J Trichology 2022; 14:213-215. [PMID: 37034548 PMCID: PMC10075349 DOI: 10.4103/ijt.ijt_9_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/14/2022] [Accepted: 06/14/2022] [Indexed: 03/14/2023] Open
Abstract
Ichthyosis follicularis with alopecia and photophobia (IFAP) syndrome is a rare congenital genetic disorder characterized clinically by a triad of follicular ichthyosis, alopecia and photophobia. The genetic inheritance pattern in IFAP syndrome is said to be X-linked with mutations of the membrane-bound transcription factor peptidase, site 2 gene. Histopathology of the skin shows dilated hair follicles with keratin plugs extending above the surface of the skin. In this case report, we describe a 6-year-old girl with clinical features of IFAP along with palmoplantar keratoderma. Skin biopsy was done to confirm the diagnosis after which she was started on acitretin (10 mg per day). Good improvement in cutaneous features was observed after 1 month.
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Affiliation(s)
- Supriya Rajesh
- Department of Dermatology, Venerology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Eswari Loganathan
- Department of Dermatology, Venerology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Asha Gowrappala Shanmukhappa
- Department of Dermatology, Venerology and Leprosy, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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Sánchez-Díaz M, Díaz-Calvillo P, Rodríguez-Pozo JÁ, Arias-Santiago S, Molina-Leyva A. Effectiveness and Safety of Acitretin for the Treatment of Hidradenitis Suppurativa, Predictors of Clinical Response: A Cohort Study. Dermatology 2022; 239:52-59. [PMID: 35998603 DOI: 10.1159/000526019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 01/13/2022] [Accepted: 07/01/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle which presents with painful nodules, abscesses, and fistulae in apocrine gland-bearing areas of the skin. Approved treatments include antibiotics and biologic drugs such as adalimumab. Despite these treatments, HS management is challenging. Acitretin is an oral retinoid used for its management as 3rd or 4th line therapy. There is little evidence regarding the effectiveness and safety of acitretin treatment for HS, and no reports have previously explored the potential clinical predictors associated with the response to the treatment. METHODS Retrospective cohort study to assess the effectiveness and safety of acitretin treatment in HS patients who failed to respond to topical therapies. RESULTS Sixty-two patients with moderate to severe HS were included. A significant decrease in the International HS Severity Scoring System (IHS4) score was found over time. Higher basal IHS4 score, family history of HS, follicular phenotype, and history of follicular plugging conditions were potential predictors of response. Most patients did not suffer any adverse events, and no severe side effects were observed. The main cause of discontinuation was lack of efficacy. CONCLUSION Acitretin can be considered as a therapeutic option for patients with HS. The presence of follicular phenotype or a history of components of follicular occlusion syndrome is associated with better outcomes.
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Affiliation(s)
- Manuel Sánchez-Díaz
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain
| | - Pablo Díaz-Calvillo
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain
| | | | - Salvador Arias-Santiago
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Dermatology Department, School of Medicine, University of Granada, Granada, Spain
| | - Alejandro Molina-Leyva
- Dermatology Unit, Hospital Universitario Virgen de las Nieves, IBS Granada, Granada, Spain.,Dermatology Department, School of Medicine, University of Granada, Granada, Spain.,Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Yang Y, Zhao Y, Liu J, Ge C, Zhang W, Zhang Y, Wang J, Sun G, Lin X, Lu X, Tang X, He J, Lu W, Qin J. Novel Self-Assembled Micelles With Increased Tumor Penetration and Anti-Tumor Efficiency Against Breast Cancer. Pharm Res 2022; 39:2227-2246. [PMID: 35902533 DOI: 10.1007/s11095-022-03338-3] [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: 02/28/2022] [Accepted: 07/06/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Recently, docetaxel (DTX) micelles based on retinoic acid derivative surfactants showed lower systemic toxicity and bioequivalence to polysorbate-solubilized docetaxel (Taxotere®) in a phase II clinical study. However, the poor stability of these surfactants in vitro and in vivo led to extremely harsh storage conditions with methanol, and the formed micelles were quickly disintegrated with rapid drug burst release in vivo. To further enhance the stability and accumulation in tumors of DTX micelles, a novel surfactant based on acitretin (ACMeNa) was synthesized and used to prepare DTX micelles to improve anti-tumor efficiency. METHODS Novel micelle-forming excipients were synthesized, and the micelles were prepared using the thin film hydration technique. The targeting effect in vitro, distribution in the tumor, and its mechanism were observed. Pharmacokinetics and anti-tumor effect were further investigated in rats and tumor-bearing female mice, respectively. RESULTS The DTX-micelles prepared with ACMeNa (ACM-DTX) exhibited a small size (21.9 ± 0.3 nm), 39% load efficiency, and excellent stability in vitro and in vivo. Long circulation time, sustained and steady accumulation, and strong penetration in the tumor were observed in vivo, contributing to a better anti-tumor effect and lower adverse effects. CONCLUSIONS The micelles formed by ACMeNa showed a better balance between anti-tumor and adverse effects. It is a promising system for delivering hydrophobic molecules for cancer therapy.
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Affiliation(s)
- Yani Yang
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Yuezhu Zhao
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Jie Liu
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
- Department of Pharmaceutics, School of Pharmacy, Fudan University & Key Laboratory of Smart Drug Delivery, Ministry of Education, Shanghai, 201203, People's Republic of China
| | - Chen Ge
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Weiwei Zhang
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Yue Zhang
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Junji Wang
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Guohao Sun
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Xiujun Lin
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Xiaohong Lu
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Xiang Tang
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China
| | - Jun He
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China.
| | - Weigen Lu
- National Pharmaceutical Engineering Research Center, China State Institute of Pharmaceutical Industry, Shanghai, 201203, People's Republic of China.
| | - Jing Qin
- Department of Pharmaceutics, School of Pharmacy, Fudan University & Key Laboratory of Smart Drug Delivery, Ministry of Education, Shanghai, 201203, People's Republic of China.
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Agrawal A, Elhence P, Patra S. Pseudoepitheliomatous Keratotic And Micaceous Balanitis presenting as cutaneous horn and its response to acitretin. Dermatol Ther 2022; 35:e15733. [PMID: 35882770 DOI: 10.1111/dth.15733] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Akriti Agrawal
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences (AIIMS) Jodhpur
| | | | - Suman Patra
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences (AIIMS) Jodhpur
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Silva-Hirschberg C, Cabrera R, Rollán MP, Castro A. Darier disease: the use of dermoscopy in monitoring acitretin treatment. An Bras Dermatol 2022; 97:644-647. [PMID: 35853773 PMCID: PMC9453516 DOI: 10.1016/j.abd.2021.05.021] [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: 03/25/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/02/2022] Open
Abstract
Darier disease is an uncommon autosomal dominant inherited disease, caused by a mutation in the ATP2A2 gene. The clinical findings are hyperkeratotic papules on the trunk, scalp, face, and neck, maceration of intertriginous areas, palmar pits, whitish papules on the oral mucosa and nail abnormalities. The main histopathologic findings are acantholysis and dyskeratotic keratinocytes. Dermatoscopic features are comedo-like openings with a central polygonal yellowish/brownish structure, surrounded by a whitish halo. First-line treatment includes acitretin. Five reports have been published describing Darier disease dermatoscopic findings. Herein, we report for the first time a patient under acitretin treatment and dermatoscopic follow-up.
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Affiliation(s)
- Catalina Silva-Hirschberg
- Department of Dermatology, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
| | - Raúl Cabrera
- Department of Dermatology, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - María Paz Rollán
- Department of Dermatology, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Alex Castro
- Department of Pathology, Facultad de Medicina, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
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Ye T, Li D, Yang L, Liu X, Jiang B, Chen B, Zou Y, Yu B. Acitretin Enhances the Cytotoxic Effect of 5-aminolevulinic Acid Photodynamic Therapy on Squamous Cell Carcinoma Cells. Photodiagnosis Photodyn Ther 2022;:102969. [PMID: 35714900 DOI: 10.1016/j.pdpdt.2022.102969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/06/2022] [Accepted: 06/14/2022] [Indexed: 11/22/2022]
Abstract
The efficacy of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) on invasive cutaneous squamous cell carcinoma (cSCC) remains to be improved due to the limited penetration of this treatment. Previous study showed that acitretin and ALA-PDT had synergistic effect on cSCC, but whether acitretin can enhance the cytotoxic effect of ALA-PDT on cSCC is unclear. OBJECTIVE To investigate whether acitretin can enhance the cytotoxic effect of ALA-PDT on SCL-1 cells, as well as the possible mechanism involved. METHODS Inverted microscopy, trypan blue exclusion assay, and flow cytometry were used to studied the morphology, viability and apoptosis of SCL-1 cells treated with acitretin, ALA-PDT and acitretin followed by ALA-PDT treatment, respectively. Confocal microscopy was applied to detect the ROS formation of SCL-1 cells treated with acitretin of four different concentrations. The ROS formation of SCL-I cells treated with acitretin of four different concentrations followed by ALA-PDT treatment was detected using confocal microscopy and flow cytometry. RESULTS SCL-1 cells exhibited a significant morphological alteration when treated with acitretin followed by ALA-PDT. The combination of acitretin and ALA-PDT induced a higher cell death rate and apoptosis than that with acitretin or ALA-PDT treatment alone. ROS could be induced when incubated with acitretin at a concentration of 6.4 × 10-4mg /mL or above. However, a higher level of ROS formation was observed when SCL-1 cells were treated with acitretin followed by ALA-PDT than that with ALA-PDT or acitretin alone. CONCLUSION Acitretin can enhance the cytotoxic effect of ALA-PDT on SCL-1 cells, possibly via the ROS pathway.
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Abu Nasra NO, Elzayat EM, Dawood KM, Hagag NM, Yehya MM, Hosney M. Regulatory Effect of Adipose-Derived Mesenchymal Stem Cells and/ or Acitretin on Adam10 Gene in Alzheimer's disease Rat Model. Curr Stem Cell Res Ther 2022; 17:370-388. [PMID: 35236271 DOI: 10.2174/1574888x17666220302154618] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/15/2021] [Accepted: 12/22/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by progressive cognitive deterioration. All recent therapeutic strategies tend to inhibit the generation of the Aβ peptide. These approaches tend to mediate both α- and γ-secretases to undergo the non-amyloidogenic pathway. ADAM10 is the main α-secretase that cleaves APP, and it is regulated by the metabolic product of vitamin A (retinoic acid), which is being widely used recently in AD research as a target for treatment. Mesenchymal stem cells (MSCs) are also used recently as a promising regenerative therapy for AD. OBJECTIVES The present study aimed to: (1) study the effect of MSCs with/without acitretin on the regulation of Adam10 gene expression in AlCl3-induced AD rat model, (2) validate the hypothesis that AD is a time-dependent progressive disease that spreads spontaneously even after the stopping of exposure to AlCl3. METHODS The experimental work has been designed to include three successive phases; AlCl3 induction phase (I), AlCl3 withdrawal phase (W), and therapeutic phase (T). Forty-five male albino Wistar rats were randomly divided into 2 main groups: the control (C) group (15 rats) and AD group (30 rats). The therapeutic potential of MSCs with/without acitretin has been evaluated at behavioral, physiological, molecular, and histopathological levels Results: Among the three therapeutic groups, combined administration of both MSC and acitretin showed the best compensatory effects on most of the measured parameters. CONCLUSION The present study approved that AD is a time-dependent progressive disease and spreads spontaneously without more AlCl3 exposure.
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Affiliation(s)
- Noha O Abu Nasra
- Biotechnology/Bimolecular Chemistry Program, Faculty of Science, Cairo University, 12613, Giza, Egypt
| | - Emad M Elzayat
- Zoology Department, Faculty of Science, Cairo University, 12613, Giza, Egypt
| | - Kamal M Dawood
- Department of Chemistry, Faculty of Science, Cairo University, 12613, Giza, Egypt
| | - Naglaa M Hagag
- Genome Research Unit, Animal Health Research Institute, Agriculture Research Center, 12618, Giza, Egypt
| | - Manal M Yehya
- Pathology Department, Animal Health Research Institute, Agriculture Research Center, 12618, Giza, Egypt
| | - Mohamed Hosney
- Zoology Department, Faculty of Science, Cairo University, 12613, Giza, Egypt
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15
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Sachdev SS, Jamil A, Gunabalasingam P, Safdar NA. The Effects of Acitretin on Insulin Resistance, Glucose Metabolism, and Lipid Levels in Patients with Psoriasis. Indian J Dermatol 2022; 67:349-354. [PMID: 36578705 PMCID: PMC9792046 DOI: 10.4103/ijd.ijd_328_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: 12/30/2022] Open
Abstract
Context Acitretin increases serum lipids. Data on its effects on insulin resistance and glucose metabolism are sparse and contradicting. Aims The aim of this study is to investigate the effects of acitretin on insulin resistance, glucose metabolism, and lipids. Methods Dermatology clinic in a public tertiary hospital. A cross sectional study involving chronic plaques psoriasis patients on acitretin plus topical therapy or topical therapy alone was performed. Fasting blood glucose (FBG), serum lipids, serum insulin, and glucose tolerance test (GTT) were performed. Homeostatic model of insulin resistance (HOMA-IR) was calculated. Psoriasis severity was evaluated using Psoriasis Area and Severity Index. Chi square and t-tests determined differences between cases and controls. Pearson's correlation coefficient test determined the relationship between continuous variables. Results A total of 60 patients participated, 30 were on acitretin while 30 were on topical therapy. Psoriasis duration, disease severity, BMI, presence of metabolic syndrome, and other comorbidities between the two groups were similar. There were no significant differences in GTT, FBG, HOMA-IR, and serum lipids. Patients on acitretin >25 mg daily had lower FBG [4.4 (0.8) versus 4.9 (0.9), P = 0.04] and triglyceride [1.05 (0.33) versus 1.57 (1.03), P = 0.02] compared with doses ≤25 mg. Higher acitretin dose correlated with lower FBG (r = -0.36, P = 0.05) and triglycerides (r = -0.37, P = 0.05) while longer therapy duration correlated with lower total cholesterol (r = -0.37, P = 0.05). HOMA-IR showed inverse correlation with acitretin dose and duration (r = -0.10, P = 0.61 and r = -0.12, P = 0.53, respectively). Conclusion Acitretin therapy resulted in increased triglyceride. The effect of acitretin on glucose metabolism and insulin resistance maybe dependent on the dose and duration of therapy.
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Affiliation(s)
- Satnam Singh Sachdev
- From the Dermatology Department, Hospital Tuanku Jaafar, Jalan Rasah, Bukit Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Adawiyah Jamil
- Dermatology Unit, Department of Medicine, University Kebangsaan Malaysia Medical Center, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia,Address for correspondence: Prof. Adawiyah Jamil, Derpartment of Medicine, University Kebangsaan Malaysia Medical Center, Bandar Tun Razak, Cheras, Kuala Lumpur - 56000, Malaysia. E-mail:
| | - Preamala Gunabalasingam
- From the Dermatology Department, Hospital Tuanku Jaafar, Jalan Rasah, Bukit Rasah, Seremban, Negeri Sembilan, Malaysia
| | - Najeeb Ahmad Safdar
- From the Dermatology Department, Hospital Tuanku Jaafar, Jalan Rasah, Bukit Rasah, Seremban, Negeri Sembilan, Malaysia
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16
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Rani S, Sachdeva S. Pseudogynecomastia: A chance occurrence with acitretin. Indian J Pharmacol 2021; 53:388-390. [PMID: 34854408 PMCID: PMC8641749 DOI: 10.4103/ijp.ijp_982_20] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Psoriatic involvement of nails manifests in the form of irregular, deep and large pits, splinter hemorrhages, subungual hyperkeratosis, oil drop spot, and onycholysis of the nail bed. Retinoids are one of the treatment modalities for nail psoriasis. Pseudogynecomastia is an uncommonly reported side effect of retinoids. We hereby describe an 11-year-old adolescent who developed pseudogynecomastia posttreatment with acitretin for nail psoriasis.
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Affiliation(s)
- Seema Rani
- Department of Dermatology, Dr. RMLH, ABVIMS, New Delhi, India
| | - Soumya Sachdeva
- Department of Dermatology, Dr. RMLH, ABVIMS, New Delhi, India
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17
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Abstract
Psoriasis may affect the skin, scalp, joints, and nails and is common in older adults. Intramatrical injections with triamcinolone acetonide are safe and effective in older individuals. Conventional systemic medications are relatively effective, but side effects, including laboratory abnormalities and drug interactions, are particularly common among older adults. Biologic medications have shown excellent efficacy in treating nail psoriasis. Their safety profile is favorable, but data assessing long-term safety are lacking. Randomized controlled trials in older adults exclusively are necessary to develop evidence-based treatment guidelines in this population.
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Affiliation(s)
- Jose W Ricardo
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA.
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18
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Rolf D, Elsayad K, Eich HT. Acute and sub-acute toxicity profile of ultra-hypofractionated low-dose total skin electron beam with two 4 Gy fractions for cutaneous T cell lymphoma. J Cancer Res Clin Oncol 2020; 147:1757-1761. [PMID: 33219856 PMCID: PMC7680066 DOI: 10.1007/s00432-020-03449-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/31/2020] [Indexed: 12/14/2022]
Abstract
Purpose Low-dose total skin electron beam therapy (TSEBT) over 3 weeks has proved to be a safe and effective treatment for cutaneous T cell lymphomas (CTCL). In this prospective trial, we examined the feasibility of ultra-hypofractionated low-dose TSEBT regimen in two fractions with 4 Gy combined with systemic therapy to minimize the number of visits to radiation centers. Patients and methods Six patients with mycosis fungoides (MF) or Sézary syndrome (SS) received TSEBT with a total radiation dose of 8 Gy in two fractions between April 2020 and June 2020. Patient and treatment characteristics, tumor burden, the impact on the quality of life using Skindex-29 questionnaires, and acute toxicities were analyzed. Results During TSEBT, all patients developed grade 1 toxicities while two patients developed grade 2 toxicities. One patient experienced sepsis. The most common adverse effects were erythema and edema. All grade 2 toxicities regressed after 4 weeks following TSEBT. Based on the reported symptoms measured by Skindex-29, we detected a significant reduction in total Skindex-29 score after 8 weeks of radiation (P = 0.03), particularly in the symptoms (P = 0.01) and emotional domains (P = 0.04). Conclusion Ultra-hypofractionated low-dose TSEBT followed by systemic therapy seems to be a safe and feasible alternative to conventional fractionated TSEBT for patients with MF/SS. The skin tumor burden and the health-related quality of life have been significantly improved within 8 weeks following radiotherapy.
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Affiliation(s)
- Daniel Rolf
- Department of Radiation Oncology, University Hospital of Muenster, Building A1, 1 Albert Schweitzer Campus, 48149, Muenster, Germany
| | - Khaled Elsayad
- Department of Radiation Oncology, University Hospital of Muenster, Building A1, 1 Albert Schweitzer Campus, 48149, Muenster, Germany.
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital of Muenster, Building A1, 1 Albert Schweitzer Campus, 48149, Muenster, Germany
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19
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Relvas M, Calvão J, Coutinho I, Cardoso JC. Case for diagnosis. A pruritic eruption of keratotic papules over the face and neck. An Bras Dermatol 2021; 96:100-2. [PMID: 33281010 DOI: 10.1016/j.abd.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/02/2020] [Indexed: 11/25/2022] Open
Abstract
Generalized eruptive keratoacanthoma of Grzybowski is a rare variant of multiple keratoacanthomas counting with about 40 cases reported. It is a chronic and progressive disease for which none of the described therapeutic options has been entirely satisfactory. We report a case of an 83-year-old female who presented with a 3-month history of extremely pruritic, multiple, skin-coloured to erythematous to brownish, millimetric papules, with a keratotic centre. Histological examination of an incisional biopsy was consistent with the diagnosis of keratoacanthoma. The patient started acitretin 25 milligrams daily with a complete resolution of pruritus and regression of numerous lesions.
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20
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Williams A, George A, Thomas EA, Koshy JM. Pityriasis rubra pilaris type 6: A case report in an AIDS patient. Indian J Sex Transm Dis AIDS 2020; 41:100-101. [PMID: 33062992 PMCID: PMC7529171 DOI: 10.4103/ijstd.ijstd_120_15] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/27/2016] [Accepted: 12/22/2019] [Indexed: 12/03/2022] Open
Abstract
A 24-year-old woman, known to be human immunodeficiency virus positive for 6 years, presented with an itchy rash on the body. She had dull erythematous to hyperpigmented scaly plaques over the body, with extensor predominance. Inflammatory papules and nodules were noted on the face. Follicular hyperkeratotic papules were seen on the shins, giving a “nutmeg grater” feel. All her nails were dystrophic. Histopathology was consistent with the clinical diagnosis of pityriasis rubra pilaris. CD4 counts had dropped to 192 cells/μl, so she was started on antiretroviral therapy along with acitretin to which she responded well within 2 months.
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Affiliation(s)
- Abhilasha Williams
- Department of Dermatology, Christian Medical College, Ludhiana, Punjab, India
| | - Anisha George
- Department of Dermatology, Christian Medical College, Ludhiana, Punjab, India
| | - Emy Abi Thomas
- Department of Dermatology, Christian Medical College, Ludhiana, Punjab, India
| | - Jency Maria Koshy
- Department of Medicine, Christian Medical College, Ludhiana, Punjab, India
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21
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Xu C, Su T, Ji J, Zhang M, Su Z. Photodynamic therapy with acitretin for treatment of penile verrucous carcinoma. Photodiagnosis Photodyn Ther 2020; 33:102047. [PMID: 33022419 DOI: 10.1016/j.pdpdt.2020.102047] [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: 07/07/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 11/27/2022]
Abstract
Penile verrucous carcinoma exhibits a high potential for recurrence. Traditional treatment for penile verrucous carcinoma is radical surgery. Extensive resection generally leads to the loss of the patient's sexual function and limits the tolerance for additional additional surgical resection. Herein, we present a case of penile verrucous carcinoma, who achieved complete remission after 3 sessions of PDT and 6 months Acitretin. There was no recurrence at 12 months of follow-up. This case suggests that photodynamic therapy combined with acitretin is a treatment option for penile verrucous carcinoma.
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Affiliation(s)
- Cheng Xu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Guang Zhou Rd 300, Nanjing, Jiangsu, 210029, China
| | - Ting Su
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Guang Zhou Rd 300, Nanjing, Jiangsu, 210029, China
| | - Jie Ji
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Guang Zhou Rd 300, Nanjing, Jiangsu, 210029, China
| | - Meihua Zhang
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Guang Zhou Rd 300, Nanjing, Jiangsu, 210029, China
| | - Zhonglan Su
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Guang Zhou Rd 300, Nanjing, Jiangsu, 210029, China.
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22
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Fox E, Elghobashy M, Hamad H, Moiemen N, El-Ghobashy A. Oral retinoid, acitretin, is effective in the management of resistant recurrent vulval verrucous carcinoma: A case report. J Obstet Gynaecol Res 2020; 46:2179-2184. [PMID: 32755050 DOI: 10.1111/jog.14390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/02/2020] [Accepted: 06/20/2020] [Indexed: 11/29/2022]
Abstract
Verrucous carcinomas are a rare variant of squamous cell carcinoma. Vulval verrucous carcinoma comprises only 1% of vulval malignancies. This case report discusses the successful management of aggressive recurrent vulval verrucous carcinoma with acitretin, an oral synthetic retinoid used to manage severe psoriasis, after multiple surgical interventions and radiotherapy had failed. This is the first reported case in which verrucous carcinoma had recurred in a musculocutaneous graft. To manage the recurrence, the patient underwent radiotherapy, which did not resolve the condition. The patient was then administered acitretin 25 mg once daily, which successfully resolved the condition, and the patient has been symptom free for 6 months. This report aims to propose the use of acitretin as a management option for recurrent verrucous carcinomas.
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Affiliation(s)
- Emily Fox
- Department of Gynaecological Oncology, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Mirna Elghobashy
- College of Medical and Dental Sciences, University of Birmingham Medical School, Birmingham, UK
| | - Hamdi Hamad
- Department of Dermatology, The Royal Wolverhampton NHS Trusts, Wolverhampton, UK
| | - Naiem Moiemen
- Department of Plastic Surgery, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Alaa El-Ghobashy
- Department of Gynaecological Oncology, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
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Abstract
Differentiation syndrome is a life-threatening complication observed when retinoic acid is given to patients with acute promyelocytic leukemia. Retinoid compounds are also used in non-malignant conditions like psoriasis and it is rare to see differentiation syndrome in such settings. This reports details the clinical presentation and successful management of a patient with psoriasis who developed differentiation syndrome while on treatment with acitretin. The patient was managed with steroids and the differentiation syndrome abated with eventual complete resolution. This report exemplifies the need to consider differentiation syndrome in patients who have non-malignant conditions and are being managed with retoinds.
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Affiliation(s)
- Sarah Khan
- Department of Medicine, Northeastern Health System, Tahlequah, OK, USA
| | | | - Creticus Marak
- Department of Rural Medicine - Pulmonary and Critical Care, Oklahoma State University College of Osteopathic Medicine, Tahlequah, OK, USA
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Ye T, Jiang B, Chen B, Liu X, Yang L, Xiong W, Yu B. 5-aminolevulinic acid photodynamic therapy enhance the effect of acitretin on squamous cell carcinoma cells: An in vitro study. Photodiagnosis Photodyn Ther 2020; 31:101887. [PMID: 32565180 DOI: 10.1016/j.pdpdt.2020.101887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/06/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022]
Abstract
Squamous cell carcinoma (SCC) remains the second most common nonmelanoma skin cancer (NMSC) worldwide. Both acitretin and 5-Aminolevulinic acid mediated photodynamic therapy (ALA-PDT) have validated effect on SCC. However, the effects of both treatmens remain limited, and there has been no report concerning the potential synergistic effect of both treatments for SCC. OBJECTIVE To investigate the cytotoxic effect of acitretin on SCL-1 cells, and whether ALA-PDT enhances this effect. METHODS CCK-8 and trypan blue exclusion array were used to detect the cell cytotoxicity after acitretin treatment with different concentrations (1.6 × 10-4mg/mL, 1.6 × 10-3 mg/mL, 1.6 × 10-2mg/mL and 1.6 × 10-1mg/mL) for 24 h, 48 h and 72 h. Flow cytometry and trypan blue exclusion assay were used to detect the apoptosis and viability of SCL-1 cells after treated with acitretin, ALA-PDT and ALA-PDT immediately followed by acitretin. Independent sample t test was used to analyze the different incubation time of acitretin and acitretin combined with ALA-PDT on SCL-1 cells. Bonferroni Test One-way Anova method was used to analyze the effect of different treatment on the SCL-1 cells. RESULTS A significant cytotoxic effect was observed after acitretin treatment, in an acitretin concentration-dependent manner within the range of 1.6 × 10-4mg/mL to 1.6 × 10-1mg/mL and an acitretin incubation time-dependent manner within 24 h-72 h. The total apoptosis rate and dead cells rate in group of ALA-PDT combined with acitretin were both significantly higher than that of acitretin, ALA-PDT group. A stronger apoptotic and cytotoxic effect detected 24 h after treated with acitretin than that of 12 h was observed in this study. CONCLUSION Acitretin has a cytotoxic effect on SCL-1 cells, and ALA-PDT treatment enhances the the cytotoxic effect of acitretin.
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Affiliation(s)
- TingLu Ye
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Bin Jiang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - BanCheng Chen
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - XiaoMing Liu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - LiLi Yang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Wei Xiong
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Bo Yu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
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25
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Auriti C, Rotunno R, Diociaiuti A, Manzoni SM, Uva A, Bersani I, Santisi A, Dotta A, El Hachem M. Juvenile idiopathic arthritis in infants with Harlequin Ichthyosis: two cases report and literature review. Ital J Pediatr 2020; 46:44. [PMID: 32293521 PMCID: PMC7158043 DOI: 10.1186/s13052-020-0817-5] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
Abstract
Background Harlequin Ichthyosis is the most severe variant of congenital autosomal recessive ichthyosis, associated with severe morbidity and potentially lethal in early life. At birth, patients present thick and plaque-like scales all over the body, with consequent cutaneous and extra-cutaneous complications, such as poor thermoregulation, recurrent infections, pain, electrolytes imbalance and joint contractures. Juvenile Idiopathic Arthritis usually manifests before the age of 16 years and persists for more than 6 weeks. The association between these two pathologies has been described in the literature as a very rare event, which creates diagnostic and therapeutic challenge. Case presentation We describe two patients affected by Harlequin Ichthyosis who early developed Juvenile Idiopathic Arthritis. Both patients were treated with retinoids, ibuprofen and long-acting intra-articular glucocorticoids; due to polyarticular involvement, one child was also treated with weekly oral methotrexate. Conclusions The association between Harlequin Ichthyosis and Juvenile Idiopathic Arthritis is rare and the pathophysiological mechanism that binds them is still unknown. Nonetheless caregivers should be aware of the possible occurrence of Juvenile Idiopathic Arthritis at very early ages in children affected by Harlequin Ichthyosis.
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Affiliation(s)
- Cinzia Auriti
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCSS, Piazza S. Onofrio 4, 00165, Rome, Italy.
| | - Roberta Rotunno
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Diociaiuti
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Andrea Uva
- Rheumatology Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Pediatrics Department, Umberto I Hospital, La Sapienza University, Rome, Italy
| | - Iliana Bersani
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCSS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Alessandra Santisi
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCSS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Andrea Dotta
- Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, IRCSS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - May El Hachem
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Tu J, Yin Z, Guo J, He F, Long F, Yin Z. Acitretin inhibits IL-17A-induced IL-36 expression in keratinocytes by down-regulating IκBζ. Int Immunopharmacol 2019; 79:106045. [PMID: 31863918 DOI: 10.1016/j.intimp.2019.106045] [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: 08/16/2019] [Revised: 10/28/2019] [Accepted: 11/10/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND IL-36 plays a critical role in aggravating psoriatic inflammation, which is significantly elevated in generalized pustular psoriasis (GPP) compared to psoriasis vulgaris. It is well known that acitretin brings about a rapid and significant effect on the treatment of GPP but not psoriasis vulgaris, whereas the quick therapeutic mechanism of acitretin in GPP has not been fully clarified. OBJECTIVES We conducted this study to investigate whether acitretin interferes IL-36 expression in keratinocytes. METHOD We used 100 ng/mL IL-17A and/or various doses of acitretin (0, 0.1, 1, 10 μmol/L) to treat cultured HaCaT cells. We performed Real-time quantitative PCR and ELISA to detect gene and protein expression of IL-36 cytokines, real-time quantitative PCR and Western blot to examine IκBζ. Imiquimod (IMQ)-induced psoriasis-like mouse model was established to evaluate effect of gastrointestinal administrated acitretin. Immunohistochemistry was conducted for effect assessment. RESULTS Acitretin significantly down-regulated expression of IL-36β and IL-36γ induced by IL-17A stimulation at both gene and protein levels in HaCaT cells. Acitretin alone had no obvious effect on IL-36 expression in keratinocytes. In IMQ + acitretin group, the skin lesion severity was slightly relieved, however, immunohistochemistry showed IL-36β and IL-36γ expression in keratinocytes significantly declined in comparison with IMQ group. IL-17A stimulation induced significantly IκBζ expression in HaCaT cells, which could be inhibited by acitretin. CONCLUSION Acitretin inhibits IL-36 expression induced by IL-17A stimulation in keratinocytes by down-regulating IκBζ, and acitretin significantly inhibits keratinocytes-expressed IL-36β and IL-36γ in psoriasis-like mouse model, which reveals a new possible mechanism of the notable and quick therapeutic action of acitretin on GPP.
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Affiliation(s)
- Jie Tu
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhi Yin
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Guo
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Deparment of Dermatology, Zhenjiang First People's Hospital, Zhenjiang, China
| | - Fang He
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - FangYuan Long
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - ZhiQiang Yin
- Department of Dermatology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Patro N, Panda M, Mohanty PK. Congenital ichthyosiform erythroderma: A rare neonatal dermatoses responding to acitretin. Indian J Pharmacol 2019; 51:343-345. [PMID: 31831924 PMCID: PMC6892013 DOI: 10.4103/ijp.ijp_124_17] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 12/03/2022] Open
Abstract
Congenital ichthyosiform erythroderma is a rare and severe form of ichthyosis manifesting in the neonatal age group. We report a child with diffuse peeling of skin and erythroderma presenting on the 2nd day of birth. With aseptic nursing care along with emollients and oral acitretin, the child's quality of life improved remarkably, hence highlighting the point of early and judicious use of acitretin in reducing disease morbidity.
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Affiliation(s)
- Nibedita Patro
- Department of Skin and VD, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
| | - Maitreyee Panda
- Department of Skin and VD, IMS and SUM Hospital, Bhubaneswar, Odisha, India
| | - Pankaj Kumar Mohanty
- Department of Paediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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28
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Mielanczyk A, Mrowiec K, Kupczak M, Mielanczyk Ł, Scieglinska D, Gogler-Piglowska A, Michalski M, Gabriel A, Neugebauer D, Skonieczna M. Synthesis and in vitro cytotoxicity evaluation of star-shaped polymethacrylic conjugates with methotrexate or acitretin as potential antipsoriatic prodrugs. Eur J Pharmacol 2019; 866:172804. [PMID: 31738938 DOI: 10.1016/j.ejphar.2019.172804] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 07/31/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 02/07/2023]
Abstract
Water-soluble polymer-drug conjugates were obtained and analyzed towards their potential use as prodrugs for two hydrophobic antipsoriatic agents, including methotrexate (MTX) and acitretin (AC). The conjugation efficacy of MTX decreased with a decreasing molar ratio of N,N-dimethylaminoethyl methacrylate (DMAEMA) repeating units in the polymethacrylic chains. Cytotoxicity of positively charged (from +5 to +10 mV) nano- and microparticles (3-1500 nm in DMEM at 37 °C) were estimated by in vitro MTT and Annexin-V apoptosis assays on Me45, NHDF, HaCaT and BEAS-2B cell lines. Further, cell cycle analysis revealed arrest in G0/G1 phase in melanoma cells, while neither apoptosis induction nor cell cycle arrest occurred in normal epidermal and epithelial cells. Tested conjugates displayed a novel cytostatic effect in Me45 cells and a pro-apoptotic effect in HaCaT cells. Epithelial BEAS-2B cells were the most sensitive to the tested conjugates and responded via induction of necrosis. Cell line models allowed for characterization of the biologically relevant potential action of pro-drugs. Additionally, a skin in vitro evaluation assay provided the first known evidence of side-effect reduction with pro-drug use. Histological examinations confirmed the lack of negative effects of conjugates on the skin and showed no irritating properties.
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Affiliation(s)
- Anna Mielanczyk
- Department of Physical Chemistry and Technology of Polymers, Faculty of Chemistry, Silesian University of Technology, M. Strzody 9 Street, 44-100, Gliwice, Poland.
| | - Katarzyna Mrowiec
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Maria Kupczak
- Department of Physical Chemistry and Technology of Polymers, Faculty of Chemistry, Silesian University of Technology, M. Strzody 9 Street, 44-100, Gliwice, Poland
| | - Łukasz Mielanczyk
- Department of Histology and Cell Pathology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Dorota Scieglinska
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Agnieszka Gogler-Piglowska
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Marek Michalski
- Department of Histology and Cell Pathology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Andrzej Gabriel
- Department of Histology and Cell Pathology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 41-808, Zabrze, Poland
| | - Dorota Neugebauer
- Department of Physical Chemistry and Technology of Polymers, Faculty of Chemistry, Silesian University of Technology, M. Strzody 9 Street, 44-100, Gliwice, Poland
| | - Magdalena Skonieczna
- System Engineering Group, Silesian University of Technology, Institute of Automatic Control, Akademicka 16, 44-100, Gliwice, Poland; Biotechnology Centre, Silesian University of Technology, Krzywoustego 8, 44-100, Gliwice, Poland.
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29
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Moussa Y, Moussa M, Abou Chakra M. Penoscrotal Elephantiasis nostras verrucosa: A case report and literature review. Int J Surg Case Rep 2019; 65:127-130. [PMID: 31704663 PMCID: PMC6920227 DOI: 10.1016/j.ijscr.2019.10.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/15/2019] [Revised: 10/15/2019] [Accepted: 10/25/2019] [Indexed: 11/24/2022] Open
Abstract
ENV is a rare disorder that results from chronic obstructive lymphedema. History and physical examination are sufficient to diagnose ENV. Etiologies of lymphatic obstruction can be a bacterial infection, malignancy, and trauma. Treatments for ENV include conservative measures to reduce lymphostasis. Surgical excision is performed in cases refractory to medical and conservative therapy.
Background Elephantiasis Nostras Verrucosa (ENV) is a rare clinical condition associated with chronic non-filarial lymphedema caused by bacterial or non-infectious lymphatic obstruction. Case description We reported an unusual case of isolated peno-scrotal ENV of a 67-year-old man with a history of Gastrointestinal Stromal Tumors (GIST) of the stomach. Our patient presented for progressive painless lymphedema of the penis and scrotum since 8 years ago before the diagnosis of GIST tumors, associated with skin changes consistent of superimposed hyperkeratotic papulonodules with a verrucose or cobblestone-like appearance. The patient refused surgical excision. He was treated with oral Acitretin 30 mg/day for 4 weeks where a minimal improvement was noted. Acitretin was stopped due to an increase in liver enzymes. Conservative treatment was applied to decrease lymphostasis. Discussion ENV is characterized by lymphedema and skin changes consisting of hyperkeratotic, verrucous and papillomatous lesions. It is most commonly caused by bacterial infection, trauma, neoplasia and obesity. The diagnosis of ENV is achieved clinically by history and typical skin changes. Imagery and skin biopsy are used to differentiate ENV from other diseases. Management of ENV remains challenging. Strategies to reduce lymph stasis include lymphatic massages, compressive dressings are often inadequate. Surgical debridement may be considered in cases where there is no improvement depsite medical therapy. Oral retinoids can be used if tolerated with variable results. Conclusion ENV is a rare disorder that results from chronic obstructive lymphedema. There is no standard therapy but a variety of medical and surgical treatment options have been reported.
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Affiliation(s)
- Yasmin Moussa
- Clinic of Dermatology, Dr. Brinkmann, Schult & Samimi-Fard. Barbarastraße 15, 45964 Gladbeck, Germany.
| | - Mohamad Moussa
- Zahraa Hospital, University Medical Center, Lebanese University, Beirut, Lebanon.
| | - Mohamed Abou Chakra
- Faculty of Medical Sciences, Department of Urology, Lebanese University, Beirut, Lebanon.
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30
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Sirka CS, Sahu K, Pradhan S, Naik S. Penile Horn: A Rare Presentation of Pseudoepitheliomatous, Keratotic, and Micaceous Balanitis Successfully Treated with Oral Acitretin. Indian Dermatol Online J 2019; 10:460-462. [PMID: 31334071 PMCID: PMC6615373 DOI: 10.4103/idoj.idoj_305_18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Glans penis is an unusual site for horn. Only few cases are reported worldwide in English literature. Pseudoepitheliomatous, keratotic, and micaceous balanitis (PKMB) is a pyodermatitis with pseudoepitheliomatous response to chronic inflammation or infection. Rarely it can develop a horn. There is one case report of PKMB presenting as penile horn and one case with nail-like presentation in the literature. Mode of treatment of PKMB with horn ranged from topical 5-fluorouracil, electrosurgery, and cryosurgery to excision. Use of oral acitretin in PKMB or penile horn is unknown. We are reporting a 60-year-old circumcised male who presented with a penile horn. Histology was suggestive of PKMB. Treatment with topical 5-flurouracil did not work. He was successfully treated with oral acitretin.
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Affiliation(s)
- Chandra Sekhar Sirka
- Department of Dermatology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kananbala Sahu
- Department of Dermatology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Swetalina Pradhan
- Department of Dermatology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Subhasini Naik
- Department of Pathology, S.C.B. Medical College, Cuttack, Odisha, India
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Baran A, Kiluk P, Świderska M, Maciaszek M, Myśliwiec H, Flisiak I. Adipocyte Fatty Acid-Binding Protein as a Novel Marker of Psoriasis and Clinical Response to Acitretin. Lipids 2019; 54:445-452. [PMID: 31281982 DOI: 10.1002/lipd.12173] [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: 12/21/2018] [Revised: 05/23/2019] [Accepted: 05/28/2019] [Indexed: 01/04/2023]
Abstract
Psoriasis is a systemic disease associated with metabolic syndrome and cardiometabolic diseases. Adipocyte fatty acid-binding protein (A-FABP, FABP4) is a relevant mediator of lipid metabolism and several comorbidities development. Aim of the study was to explore the possible role of FABP4 in psoriasis and assess its relationship with disease activity, inflammation or metabolic disturbances, and impact of systemic treatment. Fasting blood samples were obtained from 33 patients with active plaque-type psoriasis before and after 12 weeks of therapy and from 11 healthy volunteers. Serum FABP4 concentrations were analyzed by the enzyme-linked immunosorbent assay (ELISA) and statistically analyzed for their correlations with clinical outcomes and the treatment introduced. Serum FABP4 levels were significantly increased in psoriatics compared to controls (p = 0.03). No relationship between the protein and psoriasis severity expressed through psoriasis area and severity index (PASI) was noted (p = 0.57). FABP4 did not correlate with CRP (p = 0.41), lipid profile, and body mass index (BMI) nor the glucose level or liver enzyme activity. FABP4 significantly correlated with morphotic blood elements. After total therapy, FABP4 did not statistically change (p = 0.07), but significantly decreased after administering acitretin (p = 0.03). FABP4 is a potential marker of psoriasis and clinical outcome after therapy with acitretin. Adipocyte-type FABP may be related to hematological disorders or obesity-mediated comorbidities in psoriasis.
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Affiliation(s)
- Anna Baran
- Department of Dermatology and Venereology Medical University of Bialystok, 15-540 Bialystok, Zurawia 14 St, Poland
| | - Paulina Kiluk
- Department of Dermatology and Venereology Medical University of Bialystok, 15-540 Bialystok, Zurawia 14 St, Poland
| | - Magdalena Świderska
- Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Mickiewicza 2C St, Poland
| | - Magdalena Maciaszek
- Department of Infectious Diseases and Hepatology Medical University of Bialystok, 15-540 Bialystok, Zurawia 14 St, Poland
| | - Hanna Myśliwiec
- Department of Dermatology and Venereology Medical University of Bialystok, 15-540 Bialystok, Zurawia 14 St, Poland
| | - Iwona Flisiak
- Department of Dermatology and Venereology Medical University of Bialystok, 15-540 Bialystok, Zurawia 14 St, Poland
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Abstract
The treatment of hair loss is a challenge for all dermatologists. New medications are needed due to lack of efficacy of many treatments or their side-effect profile. This article discusses the most recent literature updates on the use of retinoids in frontal fibrosing alopecia, platelet-rich plasma in androgenetic alopecia, and JAK inhibitors in alopecia areata.
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Affiliation(s)
- Leopoldo Duailibe Nogueira Santos
- Santa Casa of São Paulo School of Medicine, Rua Doutor Cesário Motta Júnior 61, São Paulo, SP 01221-020, Brazil; Municipal Public Servant Hospital of São Paulo, Rua Castro Alves 60, São Paulo, SP 01532-000, Brazil; University of Taubaté, Av. Granadeiro Guimarães 270, Taubaté, SP 12020-130, Brazil; The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 530 First Avenue, Suite 7R, New York, NY 10016, USA
| | - Jerry Shapiro
- Municipal Public Servant Hospital of São Paulo, Rua Castro Alves 60, São Paulo, SP 01532-000, Brazil.
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Duan Y, Zou J, Mao J, Guo D, Wu M, Xu N, Zhou J, Zhang Y, Guo W, Jin W. Plasma miR-126 expression correlates with risk and severity of psoriasis and its high level at baseline predicts worse response to Tripterygium wilfordii Hook F in combination with acitretin. Biomed Pharmacother 2019; 115:108761. [PMID: 31100542 DOI: 10.1016/j.biopha.2019.108761] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 11/19/2018] [Revised: 03/06/2019] [Accepted: 03/06/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Treatment of psoriasis is always difficult, which requires intensive scientific research. OBJECTIVE Tripterygium wilfordii Hook F (TwHF) with acitretin(TwHF + acitretin) is normally used in treating psoriasis. This study aimed to investigate the correlation of plasma miR-126 expression with risk and severity of psoriasis, and its predictive value of response to TwHF + acitretin treatment in psoriasis. METHODS MiRNA-126(MiR-126) expression in plasma was analyzed in psoriasis patients at month 0 (M0), M1, M3 and M6 and in health controls (HCs) at enrollment by qPCR. Psoriasis-affected body surface area (BSA) and Psoriasis Area and Severity Index (PASI) score were used to assess severity and treatment response. RESULTS Plasma miR-126 levels were decreased in psoriasis patients compared with HCs (P < 0.001), with area under the curve (AUC) of 0.771. MiR-126 expression was negatively correlated with PASI score (P = 0.001), and negatively associated with psoriasis-affected BSA (P = 0.825). At M6, 65.3% and 36.1% patients achieved PASI 50 and 75, respectively. MiR-126 increased at M1, M3 and M6 after TwHF + acitretin treatment when comparing with M0 (all P < 0.001). Meanwhile, miR-126 expression baseline in PASI 50 group declined when comparing with non-PASI 50 group (P < 0.001). Additionally, data revealed that the cause of high miR-126 baseline level was due to unsuccessfully achieving PASI 50 at M6 after TwHF + acitretin treatment (P < 0.001). However, miR-126 baseline expression was not a predictive factor for PASI 75 achievement (P > 0.05). CONCLUSION Plasma miR-126 expression is negatively correlated with psoriasis risk and severity, and its high baseline level can be used as a biomarker to predict worse clinical response to TwHF + acitretin treatment in psoriasis.
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Affiliation(s)
- Yanjuan Duan
- Department of Dermatology, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China
| | - Jialing Zou
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jingyi Mao
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Dongjie Guo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Minfeng Wu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ning Xu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jie Zhou
- Department of Dermatology, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China
| | - Yanbin Zhang
- Department of Dermatology, Seventh People's Hospital of Shanghai University of TCM, Shanghai, China
| | - Wanjun Guo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Waishu Jin
- Department of Dermatology, The Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
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Nkongolo S, Nußbaum L, Lempp FA, Wodrich H, Urban S, Ni Y. The retinoic acid receptor (RAR) α-specific agonist Am80 (tamibarotene) and other RAR agonists potently inhibit hepatitis B virus transcription from cccDNA. Antiviral Res 2019; 168:146-155. [PMID: 31018112 DOI: 10.1016/j.antiviral.2019.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 12/20/2018] [Revised: 04/14/2019] [Accepted: 04/17/2019] [Indexed: 01/01/2023]
Abstract
Chronic infection with the human Hepatitis B virus (HBV) is a major global health problem. Hepatitis D virus (HDV) is a satellite of HBV that uses HBV envelope proteins for cell egress and entry. Using infection systems encoding the HBV/HDV receptor human sodium taurocholate co-transporting polypeptide (NTCP), we screened 1181 FDA-approved drugs applying markers for interference for HBV and HDV infection. As one primary hit we identified Acitretin, a retinoid, as an inhibitor of HBV replication and HDV release. Based on this, other retinoic acid receptor (RAR) agonists with different specificities were found to interfere with HBV replication, verifying that the retinoic acid receptor pathway regulates replication. Of the eight agonists investigated, RARα-specific agonist Am80 (tamibarotene) was most active. Am80 reduced secretion of HBeAg and HBsAg with IC50s < 10 nM in differentiated HepaRG-NTCP cells. Similar effects were observed in primary human hepatocytes. In HepG2-NTCP cells, profound Am80-mediated inhibition required prolonged treatment of up to 35 days. Am80 treatment of cells with an established HBV cccDNA pool resulted in a reduction of secreted HBsAg and HBeAg, which correlated with reduced intracellular viral RNA levels, but not cccDNA copy numbers. The effect lasted for >12 days after removal of the drug. HBV genotypes B, D, and E were equally inhibited. By contrast, Am80 did not affect HBV replication in transfected cells or HepG2.2.15 cells, which carry an integrated HBV genome. In conclusion, our results indicate a persistent inhibition of HBV transcription by Am80, which might be used for drug repositioning.
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Affiliation(s)
- Shirin Nkongolo
- University Hospital Heidelberg (Germany), Center for Infectious Diseases, Molecular Virology, Germany; German Center for Infection Research (DZIF), Partner Site Heidelberg, TTU Hepatitis, Germany.
| | - Lea Nußbaum
- University Hospital Heidelberg (Germany), Center for Infectious Diseases, Molecular Virology, Germany.
| | - Florian A Lempp
- University Hospital Heidelberg (Germany), Center for Infectious Diseases, Molecular Virology, Germany; German Center for Infection Research (DZIF), Partner Site Heidelberg, TTU Hepatitis, Germany.
| | - Harald Wodrich
- Laboratoire de Microbiologie Fondamentale et Pathogénicité, University of Bordeaux, France.
| | - Stephan Urban
- University Hospital Heidelberg (Germany), Center for Infectious Diseases, Molecular Virology, Germany; German Center for Infection Research (DZIF), Partner Site Heidelberg, TTU Hepatitis, Germany.
| | - Yi Ni
- University Hospital Heidelberg (Germany), Center for Infectious Diseases, Molecular Virology, Germany; German Center for Infection Research (DZIF), Partner Site Heidelberg, TTU Hepatitis, Germany.
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Mascitti H, De Masson A, Brunet-Possenti F, Bouaziz JD, Laly P, Mourad N, Garrigues JM, Laurent-Roussel S, Cavelier-Balloy B, Moulonguet I, Leschi C, Mourah S, Bagot M, Lebbé C, Basset-Seguin N. Successful Treatment of Generalized Eruptive Keratoacanthoma of Grzybowski with Acitretin. Dermatol Ther (Heidelb) 2019; 9:383-388. [PMID: 30790235 PMCID: PMC6522604 DOI: 10.1007/s13555-019-0287-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/02/2019] [Indexed: 01/08/2023] Open
Abstract
Introduction Keratoacanthomas (KA) are common cutaneous skin tumors originating from the hair follicles. Unlike squamous cell carcinoma, KA can regress spontaneously and have a benign evolution. Solitary KA is the most common form but familial multiple KA (Ferguson–Smith type), genetically predisposed KA (such as in xeroderma pigmentosum, or Muir–Torre syndrome), or sporadic multiple eruptive KA (Grzybowski type) have been described. Generalized eruptive KA of Grzybowski (GEKA) is a rare condition (around 40 reported cases). The pathophysiology is still unclear. Human papillomavirus (HPV) has been detected in sporadic KA but the presence of HPV39 has never been reported, to our knowledge, in GEKA. Case Report GEKA in an 80-year-old woman was successfully treated with acitretin (0.5 mg/kg/day) combined with surgical removal of the largest lesions. Treatment was well tolerated and led to decreased pruritus and tumor regression within 6 months. The presence of HPV39 was detected in a lesion by polymerase chain reaction and Sanger sequencing. No genetic alteration was found, in particular in the genes usually altered in squamous cell carcinoma (including NOTCH1, NOTCH2, CDKN2A, TP53). Conclusion We report a case of GEKA associated with the presence of HPV39 and the successful use of acitretin combined with surgical removal of the larger lesions.
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Affiliation(s)
- Hélène Mascitti
- Department of Dermatology, Saint-Louis Hospital, AP-HP, INSERM U976, University of Paris 7 Paris Diderot, Paris, France
| | - Adèle De Masson
- Department of Dermatology, Saint-Louis Hospital, AP-HP, INSERM U976, University of Paris 7 Paris Diderot, Paris, France
| | - Florence Brunet-Possenti
- INSERM UMR-1137, IAME, Department of Virology, Bichat Hospital, University of Paris 7 Paris Diderot, Paris, France
| | - Jean-David Bouaziz
- Department of Dermatology, Saint-Louis Hospital, AP-HP, INSERM U976, University of Paris 7 Paris Diderot, Paris, France
| | - Pauline Laly
- Department of Dermatology, Saint-Louis Hospital, AP-HP, INSERM U976, University of Paris 7 Paris Diderot, Paris, France
| | - Nadim Mourad
- Department of Dermatology, Saint-Louis Hospital, AP-HP, INSERM U976, University of Paris 7 Paris Diderot, Paris, France
| | | | - Sara Laurent-Roussel
- Department of Pathology, Saint-Louis Hospital, AP-HP, University of Paris 7 Paris Diderot, Paris, France
| | - Bénédicte Cavelier-Balloy
- Department of Pathology, Saint-Louis Hospital, AP-HP, University of Paris 7 Paris Diderot, Paris, France
| | - Isabelle Moulonguet
- Department of Pathology, Saint-Louis Hospital, AP-HP, University of Paris 7 Paris Diderot, Paris, France
| | - Cristina Leschi
- AP-HP, Saint-Louis Hospital, Department of Pharmacogenomics, INSERM UMR-S 976, University of Paris 7 Paris Diderot, Paris, France
| | - Samia Mourah
- AP-HP, Saint-Louis Hospital, Department of Pharmacogenomics, INSERM UMR-S 976, University of Paris 7 Paris Diderot, Paris, France
| | - Martine Bagot
- Department of Dermatology, Saint-Louis Hospital, AP-HP, INSERM U976, University of Paris 7 Paris Diderot, Paris, France
| | - Céleste Lebbé
- Department of Dermatology, Saint-Louis Hospital, AP-HP, INSERM U976, University of Paris 7 Paris Diderot, Paris, France
| | - Nicole Basset-Seguin
- Department of Dermatology, Saint-Louis Hospital, AP-HP, INSERM U976, University of Paris 7 Paris Diderot, Paris, France.
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Abstract
Systemic retinoids such as isotretinoin and acitretin are associated with numerous side effects but are therapeutically valuable in dermatological practice. Several studies have reported the wound-healing effects of treatment with concurrent systemic retinoids in addition to surgical treatments. Herein, we describe two patients with scar dehiscence that developed after initiation of systemic retinoid treatment following cutaneous surgery. In Case 1, isotretinoin was thought to decrease collagen production to a greater degree than did degradation during the wound remodeling phase, which resulted in wound dehiscence. In Case 2, acitretin was thought to decrease fibroblast proliferation and collagen production during the proliferation phase of wound healing, which resulted in wound dehiscence. Based on the two presented cases, it is advisable to postpone systemic retinoid treatment for 6 months to 1 year following cutaneous surgery, located especially in cosmetically important sites.
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Affiliation(s)
- Hasan Mete Aksoy
- Department of Plastic and Reconstructive Surgery, Bahcesehir University, Istanbul, Turkey.,Plastic, Reconstructive and Aesthetic Surgery Clinic, VM Medicalpark Kocaeli Hospital, Aksaray, Turkey
| | - Berna Aksoy
- Department of Dermatology, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.,Dermatology Clinic, VM Medicalpark Kocaeli Hospital Kocaeli, Aksaray, Turkey
| | - Emel Çalikoglu
- Department of Dermatology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
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Pai VV, Phadke D, Shukla P, Naik K. Fixed Tapering Dosage of Acitretin in Patients with Psoriasis: A Short-Term Analysis of Clinical Efficacy and its Effects on Biochemical Parameters. Indian J Dermatol 2019; 64:213-216. [PMID: 31148860 PMCID: PMC6537684 DOI: 10.4103/ijd.ijd_300_18] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Acitretin is a widely used systemic retinoid in the treatment of psoriasis. Dosage of acitretin in not weight adjusted due to certain interindividual variations. Objective: To evaluate the clinical efficacy and effects on biochemical parameters of fixed tapering dosage of acitretin in patients with psoriasis administered over a period of 4 weeks. Materials and Methods: This was an observational study. The study included patients of psoriasis vulgaris in the age group of 18 and 65 years with a psoriasis area severity index (PASI) score of >10 which was not responsive to topical therapy and phototherapy. Patients were given oral acitretin daily at a dose of 25 mg BD for 2 weeks, which was later tapered to 25 mg OD for another 2 weeks. The clinical efficacy and biochemical parameters were assessed. Results: Out of the 18 patients, PASI 75 was achieved in 66% of the patients by the end of the third week. Significant elevations were noted in serum lipids during 4 weeks, which returned to normal limits or near baseline levels at the end of 4 weeks. Conclusion: Fixed tapering dose of acitretin is effective in psoriasis with minimal clinical and biochemical adverse events
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Affiliation(s)
- Varadraj V Pai
- Department of Dermatology, Venereology and Leprosy, Goa Medical College, Bambolim, Goa, India
| | - Diksha Phadke
- Department of Dermatology, Venereology and Leprosy, Goa Medical College, Bambolim, Goa, India
| | - Pankaj Shukla
- Department of Dermatology, Venereology and Leprosy, Goa Medical College, Bambolim, Goa, India
| | - Krupeksha Naik
- Department of Dermatology, Venereology and Leprosy, Goa Medical College, Bambolim, Goa, India
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Ding W, Cao Y, Xing F, Tao M, Fu H, Luo H, Yang X. A Preliminary Study of the Effect of Semaphorin 3A and Acitretin on the Proliferation, Migration, and Apoptosis of HaCaT Cells. Indian J Dermatol 2019; 64:250. [PMID: 31148871 PMCID: PMC6537688 DOI: 10.4103/ijd.ijd_179_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background: Vascular endothelial growth factor (VEGF) is significantly elevated in psoriatic patients and is associated with the severity of the psoriasis. Due to the effect of inhibiting production of VEGF, acitretin can effectively treat psoriasis. Semaphorin 3A (Sema3A) restrain tumor growth and angiogenesis by partially reversing VEGF effects on tumor. However, the role of Sema3A in the pathogenesis of psoriasis is unclear. Aims and Objectives: This study aimed to investigate the effect of VEGF, Sema3A, and acitretin on HaCaT cells, to see whether Sema3A could be a beneficial factor in psoriasis, as well as acitretin. Materials and Methods: Functional analysis of VEGF, Sema3A, and acitretin was carried out using HaCaT cells cultured under different treatments. Cell counting kit-8 method, colony formation assay, flow cytometry, transwell migration, reverse transcription-polymerase chain reaction, and Western blot test were performed to measure proliferation, colony formation, migration, apoptosis, and the expression of Bcl2, Bax, Caspase 3, and Caspase 9 of HaCaT cells. Results: Sema3A and acitretin inhibited the proliferation, colony formation, and migration of HaCaT cells, while induced the apoptosis of HaCaT cells by inhibiting the expression of Bcl2, and promoting the expression of Bax, Caspase 3, and Caspase 9, which were opposite to VEGF. Sema3A and acitretin partially reversed the function of VEGF. Conclusions: Like acitretin, exogenous supplement of Sema3A may correct the abnormal proliferation and apoptosis procedure of HaCaT cells, and partially reverse the function of VEGF.
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Affiliation(s)
- Wei Ding
- Department of Dermatology, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yi Cao
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Fengling Xing
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Maocan Tao
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hongyang Fu
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hongbin Luo
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaohong Yang
- Department of Dermatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Abstract
IgA pemphigus is an exceedingly rare autoimmune blistering disorder, caused by IgA autoantibodies against desmosomal proteins. No treatment option has been found to be universally effective. The disease is often recalcitrant to oral steroids and immunosuppressants. Here, we describe the use of systemic retinoids for the treatment of recalcitrant IgA pemphigus in 3 cases. Although the use of acitretin has been reported before, we present for the first time the positive effects of alitretinoin in treatment of 2 patients with IgA pemphigus. Besides hyperlipoproteinaemia requiring use of hypolipidemic agents in one case, alitretinoin was well-tolerated and has generally a more favorable side effect spectrum than immunosuppressants.
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Affiliation(s)
- Franziska Schauer
- Department of Dermatology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 7, 79104, Freiburg, Germany
| | - Johannes Steffen Kern
- Department of Dermatology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 7, 79104, Freiburg, Germany.,Royal Melbourne Hospital, Parkville and Box Hill Hospital - Monash University Eastern Health Clinical School, Box Hill, VIC, Australia
| | - Dimitra Kiritsi
- Department of Dermatology, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstr. 7, 79104, Freiburg, Germany.
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Abstract
INTRODUCTION Psoriasis is a prevalent cutaneous condition with severe physical and psychological manifestations. Since the advent of biologics, clinical outcomes in psoriasis have improved. However, retinoids are useful in the correct clinical context. Tazarotene and acitretin are currently the only US Food and Drug Administration approved retinoids for treatment of psoriasis. Both topical tazarotene and oral acitretin act on retinoic acid receptors and retinoid-X-receptors, resulting in altered gene expression of inflammatory cytokines and inhibition of keratinocyte proliferation. Areas covered: This article provides an in-depth pharmacologic and clinical review on the use of tazarotene and acitretin in psoriasis. The PubMed database was searched using combinations of keywords: acitretin, bioavailability, dosing, efficacy, etretinate, interactions, mechanism, pharmacodynamics, pharmacokinetics, pharmacogenetics, psoriasis, safety, tazarotene, tolerability, and toxicity. Expert opinion: Tazarotene and acitretin are effective treatments for psoriasis. Benefits include lack of immunosuppression and success treating inflammatory psoriasis. When combined with other topical and systemic agents, both retinoids improve clinical efficacy while lowering the treatment threshold. However, topical adherence and bothersome side effects can limit retinoid use. Acitretin and tazarotene both improve outcomes through a unique mechanism that especially benefits subsets of patients, despite side effects and limitations.
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Affiliation(s)
- Michael S Heath
- a Department of Dermatology, Center for Dermatology Research , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Dev R Sahni
- a Department of Dermatology, Center for Dermatology Research , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Zachary A Curry
- a Department of Dermatology, Center for Dermatology Research , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Steven R Feldman
- a Department of Dermatology, Center for Dermatology Research , Wake Forest School of Medicine , Winston-Salem , NC , USA.,b Department of Pathology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,c Department of Social Sciences & Health Policy , Wake Forest School of Medicine , Winston-Salem , NC , USA
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41
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Amitay-Laish I, Reiter O, Prag-Naveh H, Kershenovich R, Hodak E. Retinoic acid receptor agonist as monotherapy for early-stage mycosis fungoides: does it work? J DERMATOL TREAT 2018; 30:258-263. [PMID: 29889596 DOI: 10.1080/09546634.2018.1487525] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Retinoids exert their biologic effects by binding to intracellular retinoic-acid receptors (RARs) and/or retinoid X receptors (RXRs). Early-stage mycosis fungoides (MF) has been effectively treated with bexarotene, an RXR-agonist, with overall response (OR) rates 54-67% and complete response (CR) rates 7-27%. Data on RAR-agonist monotherapy are limited. OBJECTIVE To analyze the effectiveness of RAR-agonist monotherapy for early-stage MF. METHODS Data on patients with early-stage MF treated with acitretin/isotretinoin monotherapy at a tertiary cutaneous lymphoma clinic in 2010-2017 were collected retrospectively from the medical files. RESULTS Thirty-five patients (26 males) of median age 50 years (range 8-83) with early-stage MF (IA 9, IB 26) underwent 37 treatment events: 25 acitretin and 12 isotretinoin at a median dosages of 0.3 mg/kg (range 0.2-0.9) and 0.2 mg/kg (range 0.1-0.7), respectively. Median time to maximal response was 6 months for both (range 1-10 for acitretin, 3-16 for isotretinoin); median treatment duration was 10 months (range 3-46) for acitretin, and 9 months (range 3-55) for isotretinoin. OR was 64% for acitretin and 80% for isotretinoin, and CR, 4% and 8%, respectively. Side-effect profiles were as previously reported for retinoids. CONCLUSIONS Early-stage MF patients may benefit from low dose RAR-agonist monotherapy, although the CR rate is low.
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Affiliation(s)
- Iris Amitay-Laish
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Ofer Reiter
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Hadas Prag-Naveh
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel
| | - Ruben Kershenovich
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel
| | - Emmilia Hodak
- a Department of Dermatology , Rabin Medical Center, Beilinson Hospital , Petach Tikva, Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
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42
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Zhou X, Zhu W, Shen M, He Y, Peng C, Kuang Y, Su J, Zhao S, Chen X, Chen W. Frizzled-related proteins 4 (SFRP4) rs1802073G allele predicts the elevated serum lipid levels during acitretin treatment in psoriatic patients from Hunan, China. PeerJ 2018; 6:e4637. [PMID: 29666772 PMCID: PMC5900929 DOI: 10.7717/peerj.4637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 01/25/2018] [Accepted: 03/27/2018] [Indexed: 12/14/2022] Open
Abstract
Background Acitretin is a second-generation synthetic retinoid, and is widely used for treating the severe psoriasis vulgaris. However, it should be chosen with caution for its cardiovascular risk, and it is reported that acitretin may increase the serum lipids. The purpose of this study is to investigate the relationship between the Frizzled-related proteins 4 (SFRP4) rs1802073 polymorphism and the changes of serum lipids in Chinese psoriatic patients during the treatment with acitretin. Methods In our study, 100 psoriatic patients were recruited systematically treated with acitretin (30 mg/day) for at least eight weeks. Data of the patients’ demographic and clinical characteristics and the results of serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were collected pre- and post-treatment. Results A total of 84 psoriatic patients were enrolled and divided into three groups by SFRP4 rs1802073 genotypes. The patients who carried with TT genotype had maintained levels of TG and LDL-C after acitretin treatment, while patients with GG/GT genotypes had significantly elevated levels of serum TG and LDL-C compared to the TT genotype (ΔTG%: 27.53 ± 59.13 vs −1.47 ± 37.79, p = 0.026, ΔLDL-C%: 10.62 ± 26.57 vs −1.29 ± 17.07, p = 0.042). The association of rs1802073 with TG and LDL-C profiles remained significant after adjusting for age, gender, and body mass index. Although without significance, the pre-post change in serum level of TC across rs1802073 GG/GT genotypes demonstrated a trend similar to TG and LDL, and the serum level of HDL-C demonstrated a trend opposite to TG, TC and LDL. Conclusions Our results demonstrated that SFRP4 rs1802073 polymorphism was found to be associated with elevated serum lipid levels after acitretin treatment, and it may serve as a genetic marker of safe and precise treatment for individual psoriatic patients.
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Affiliation(s)
- Xingchen Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China.,Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Wu Zhu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Yijing He
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Cong Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Shuang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Wangqing Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
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43
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Lin JC, Massera D, Ghalib M, Marion R, Graf L, Cohen SR, Ostfeld RJ. Hyperlipidemia secondary to acitretin therapy for lamellar ichthyosis associated with a NIPAL4 mutation improves on a plant-based diet and relapses on a standard Western diet. Clin Nutr ESPEN 2018; 24:54-57. [PMID: 29576363 DOI: 10.1016/j.clnesp.2018.01.070] [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: 10/23/2017] [Revised: 12/12/2017] [Accepted: 01/30/2018] [Indexed: 10/18/2022]
Abstract
Oral retinoids are commonly prescribed for many dermatological conditions and may induce hyperlipidemia. We document the case of a 35-year-old man taking acitretin for congenital lamellar ichthyosis associated with a homozygous deleterious mutation in NIPAL4 who developed retinoid-induced hyperlipidemia that responded dramatically to a whole-food plant-based (WFPB) diet. On presentation, his diet consisted of chicken, fish, low fat meats and dairy, grains, and some fruits and vegetables. He then adopted a WFPB diet without making changes to his medications. His serum lipid levels dropped and his exercise capacity improved. Five months later, after discontinuing the plant-based diet and returning to his baseline diet, his hyperlipidemia returned and persisted despite adjustments to his medications. After a year and a half, the patient again adopted a plant-based diet and his lipid levels fell sharply again. A WFPB diet helped improve and control serum lipid levels in a patient with retinoid-induced hyperlipidemia. Future interventions should focus on ways to help patients successfully adopt and maintain a WFPB diet, as increased adherence to a healthy lifestyle is associated with greater health benefits.
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Affiliation(s)
- Jonathan C Lin
- Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - Daniele Massera
- Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
| | - Mohammad Ghalib
- Department of Medicine, Division of Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
| | - Robert Marion
- Division of Genetic Medicine, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
| | - Lauren Graf
- Department of Clinical Nutrition, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
| | - Steven R Cohen
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - Robert J Ostfeld
- Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
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Abu Hashim II, Abo El-Magd NF, El-Sheakh AR, Hamed MF, Abd El-Gawad AEGH. Pivotal role of Acitretin nanovesicular gel for effective treatment of psoriasis: ex vivo-in vivo evaluation study. Int J Nanomedicine 2018; 13:1059-1079. [PMID: 29503541 PMCID: PMC5824759 DOI: 10.2147/ijn.s156412] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The goal of the current study was to explore the potential benefits of Acitretin (Act) nanovesicular gel as a prospective antipsoriatic topical delivery system counteracting the drug challenges in terms of its extremely low aqueous solubility, instability, skin irritation, and serious systemic adverse effects. Act-loaded niosomes were successfully developed, entirely characterized, and optimized. Further evaluation of the optimized formula was conducted regarding its stability and ex vivo cytotoxicity on different cell lines. The optimized niosomal vesicles were then incorporated in gel base matrix and investigated by sequential ex vivo (skin permeation and deposition) and in vivo (skin irritation and antipsoriatic activity using mouse tail model) experiments. The optimized Act-loaded niosomes (span 60:cholesterol molar ratio 1:1) were spherical in shape and exhibited the highest entrapment efficiency (90.32±3.80%) with appropriate nanosize and zeta potential of 369.73±45.45 nm and -36.33±1.80 mV, respectively. Encapsulation of the drug in the nanovesicles was further emphasized by differential scanning calorimetric and powder X-ray diffraction studies. After 3 months storage at 4±1°C, the optimized formula preserved its stability. Act nano niosomal gel produced a remarkable enhanced ex vivo permeation profile up to 30 h and significant drug deposition in the viable epidermal-dermal layers compared with those of Act gel. The pronounced antipsoriatic activity of the medicated nano niosomes was proved ex vivo in HaCaT cells (a keratinocyte cell line). Topical application of Act nano niosomal gel to mouse tail model further established its distinct in vivo antipsoriatic superiority in terms of significantly higher orthokeratosis, drug activity, and reduction in epidermal thickness compared with the control and other gel formulations. Also, negligible skin irritation and better skin tolerability of Act nanovesicular gel were revealed by primary irritation index and histopathologic examination.
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Affiliation(s)
| | | | - Ahmed Ramadan El-Sheakh
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Mohammed Fawzy Hamed
- Department of Pathology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
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Chokoeva AA, Wollina U, Lotti T, Maximov GK, Lozev I, Tchernev G. Disseminated Porokeratosis with Idiopathic Thrombocytopenia - Case Report and Literature Review of Porokeratosis and Related Disorders. Open Access Maced J Med Sci 2018; 6:139-142. [PMID: 29484012 PMCID: PMC5816286 DOI: 10.3889/oamjms.2018.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 08/13/2017] [Revised: 10/12/2017] [Accepted: 10/14/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND: Porokeratosis is characterised by one or more atrophic patches surrounded by a distinctive peripheral keratotic ridge, typically found on sun-exposed areas, with several clinical variants and typical histological findings. Despite ultraviolet radiation, varies antibody - related autoimmune disease treated with systemic steroids and other immunosuppressive conditions such as chronic liver disease, HIV and organ transplantations have been implicated in its etiopathology. CASE REPORT: We present a case of porokeratosis, associated with idiopathic thrombocytopenia in 74 - year old, otherwise healthy male patient, as we discuss the previously reported associated disorders. CONCLUSION: Regarding all of the polymorphism of clinical presentation, associated disorders and treatment responses, we could conclude that disseminated porokeratosis is still an unknown well disorder, which will continue to surprise the physicians in future. The screening and follow up of the patients is mandatory in all cases because as we see, porokeratosis has multiple unexpected faces, which require circumstantial clinical and paraclinical behaviour.
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Affiliation(s)
| | - Uwe Wollina
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Torello Lotti
- University G. Marconi of Rome - Dermatology and Venereology, Rome, Italy
| | | | - Ilia Lozev
- Medical Institute of Ministry of Interior Department of General, Vascular and Abdominal Surgery, Sofia, Bulgaria
| | - Georgi Tchernev
- "Onkoderma"- Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.,Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
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46
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Yorulmaz A, Yalcin B. A Painful Periungual Red Spot in a Patient with Onychodystrophy. Skin Appendage Disord 2017; 3:67-69. [PMID: 28560216 DOI: 10.1159/000457962] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 01/24/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ahu Yorulmaz
- Department of Dermatology, Ankara Numune Research and Education Hospital, Ankara, Turkey
| | - Basak Yalcin
- Department of Dermatology, Ankara Numune Research and Education Hospital, Ankara, Turkey
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47
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Qin X, Chen C, Zhang Y, Zhang L, Mei Y, Long X, Tan R, Liang W, Sun L. Acitretin modulates HaCaT cells proliferation through STAT1- and STAT3-dependent signaling. Saudi Pharm J 2017; 25:620-624. [PMID: 28579901 PMCID: PMC5447439 DOI: 10.1016/j.jsps.2017.04.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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] [Indexed: 10/31/2022] Open
Abstract
Acitretin has been a valuable option for the treatment of psoriasis, however, the molecular events of acitretin leading to the normalization of keratinocytes differentiation on psoriasis patients have not been fully explored. To investigate whether there were certain relationship between keratinocytes proliferation and JAK/STAT signaling pathways in psoriasis, and how acitretin modulated the signaling pathways. HaCaT cells, an in vitro immortal human keratinocyte cell line, was chosen as a in vitro model of psoriasis. The small interfering RNA targeting STAT1 (siRNA-STAT1) and STAT3 (siRNA-STAT3) were subsequently transfected into the HaCaT cells which were treated with or without acitretin. We found that HaCaT cells proliferation and the expression of STAT1 or STAT3 were inhibited by acitretin, siRNA-STAT1 and siRNA-STAT3. Our experimental data shows that acitretin might inhibit HaCaT cells proliferation in psoriasis by decreasing the expression of STAT- and STAT3-dependent mechanism.
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Affiliation(s)
- Xuan Qin
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.,Department of Dermatology, The First People's Hospital of Chenzhou, Chenzhou 423000, China
| | - Chunna Chen
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Yuan Zhang
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Li Zhang
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Yijie Mei
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Xinchun Long
- Department of Dermatology, The First People's Hospital of Chenzhou, Chenzhou 423000, China
| | - Rui Tan
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Wenli Liang
- Nursing School of Guangdong Pharmaceutical University, Guangzhou 510318, China
| | - Ledong Sun
- Department of Dermatology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
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An J, Zhang D, Wu J, Li J, Teng X, Gao X, Li R, Wang X, Xia L, Xia Y. The acitretin and methotrexate combination therapy for psoriasis vulgaris achieves higher effectiveness and less liver fibrosis. Pharmacol Res 2017; 121:158-168. [PMID: 28414177 DOI: 10.1016/j.phrs.2017.04.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/30/2017] [Accepted: 04/11/2017] [Indexed: 02/05/2023]
Abstract
Both acitretin and methotrexate are effective in ameliorating psoriatic lesion. However, their combination has been seldom reported in the treatment of psoriasis because of the warning regarding the potential hepatotoxicity of the drug interactions. This study was designed to investigate the effectiveness of such combination therapy for psoriasis vulgaris, and the potential benefit as well as side effect during the treatment. Thirty-nine patients with psoriasis vulgaris were treated with acitretin, methotrexate or their combination or as control. Similarly, K14-VEGF transgenic psoriasis-like mice were treated with these drugs. Human primary keratinocytes and hepatic stellate cells were used for analyzing their effect in vitro. The results showed that the combination therapy exhibited higher effectiveness in remitting skin lesion, but did not significantly affect the liver function of both patients and mice. Moreover, the combination groups showed less elevation of profibrotic factors in sera when compared with methotrexate alone groups accordingly. Furthermore, primary keratinocytes expressed more involucrin as well as loricrin and proliferated more slowly on the combined stimulation. Interestingly, such combination treatment induced lower expression of profibrotic factors in hepatic stellate cells. In conclusion, the acitretin-methotrexate combination therapy for psoriasis vulgaris can achieve higher effectiveness and result in less liver fibrosis.
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Affiliation(s)
- Jingang An
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Dingwei Zhang
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Jiawen Wu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Jiong Li
- State Key Laboratory of Biotherapy/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, China
| | - Xiu Teng
- State Key Laboratory of Biotherapy/Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, China
| | - Xiaomin Gao
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Ruilian Li
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Xiuying Wang
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Linlin Xia
- Core Research Laboratory, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China
| | - Yumin Xia
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China.
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Gulasi S. Congenital Ichthyosis: A Case Treated Successfully With Acitretin. Iran J Pediatr 2017; 26:e2442. [PMID: 28203322 PMCID: PMC5297259 DOI: 10.5812/ijp.2442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 01/13/2016] [Accepted: 04/27/2016] [Indexed: 11/22/2022]
Abstract
Introduction Lamellar ichthyosis (collodion baby) is a cornification disorder classified under the category of autosomal recessive congenital ichthyosis and characterized by hyperkeratosis. Early-stage retinoid treatment has been shown to improve survival in these patients. In this article, a lamellar ichthyosis case is presented of an infant who had the symptoms at birth and was treated successfully with acitretin. Case Presentation A term newborn infant presented after delivery. Physical examination showed that the skin on her outer mouth, neck, axillae, and inguinal fold areas had collodion membranes and peelings. On the third day of life, the skin all over her body became dry and seemed similar to parchment paper, with peeling in some areas, as well as ectropion and eclabium development. After her daily bath, liquid Vaseline was applied all over her body, but it did not provide enough benefits. The infant was started on acitretin treatment. On the 14th day of treatment, the skin appeared nearly normal. On the 28th day of life, the infant was discharged. Conclusions Early oral retinoid treatment facilitates increased quality of life improves survival rates for ichthyosis patients.
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Affiliation(s)
- Selvi Gulasi
- Department of Pediatrics, Adana Numune Research and Training Hospital, Adana, Turkey
- Corresponding author: Selvi Gulasi, Department of Pediatrics, Adana Numune Research and Training Hospital, Adana, Turkey. Tel: +90-5323930542, E-mail:
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Wang Y, Cheng R, Lu Z, Guo Y, Yan M, Liang J, Huang P, Li M, Yao Z. Clinical profiles of pediatric patients with GPP alone and with different IL36RN genotypes. J Dermatol Sci 2016; 85:235-240. [PMID: 28063630 DOI: 10.1016/j.jdermsci.2016.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 06/14/2016] [Revised: 11/04/2016] [Accepted: 11/21/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND IL36RN mutation has been identified as one pathogenesis of generalized pustular psoriasis, but the existence of GPP patients without mutation makes this controversial. OBJECTIVE Our study aimed at assessing the differences in clinical profiles of children with GPP, with and without IL36RN mutation. METHODS An ambispective case series study involved review of the records of 66 childhood patients with pediatric-onset GPP and without previous psoriasis vulgaris. RESULTS c.115+6T>C was the most common mutation in this Chinese population with GPP alone. The age at onset was nearly halved in the homozygotes/compound heterozygotes than in IL36RN-negative patients. Besides a more severe inflammatory progression, three minor signs could prioritize patients with GPP for IL36RN screening (confluent lakes of pus (P=0.002), perianal erosion (P=0.014), and flexural erosion (P=0.007)). More patients with the pathogenic mutation converted to ACH than those without mutation (χ2=4.773, P=0.029). Children with GPP with or without IL36RN mutation responded well to oral low-dose acitretin, but IL36RN-positive cases suffered a much higher half-year recurrence rate after withdrawl of acitretin treatment(χ2=10.370, P=0.001). CONCLUSIONS Specific clinical features can remind dermatologists of the necessity of sequencing diagnosis. The mild pustular phenotype of those without mutation may imply the possible role of the epigenetic changes of IL36RN, or other IL36-blockers in the pathogenesis. Pediatric patients with GPP alone, both with and without IL36RN mutation responded well to low-dose acitretin.
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Affiliation(s)
- Yirong Wang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ruhong Cheng
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhiyong Lu
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yifeng Guo
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ming Yan
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianying Liang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Peichen Huang
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ming Li
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Zhirong Yao
- Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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