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Bonnesen K, Poulsen CFB, Schmidt SAJ, Sørensen HT, Schmidt M. Autoimmune blistering disorders and cardiovascular risks: A population-based cohort study. J Am Acad Dermatol 2024:S0190-9622(24)00486-9. [PMID: 38492858 DOI: 10.1016/j.jaad.2024.02.052] [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: 10/30/2023] [Revised: 01/22/2024] [Accepted: 02/27/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Autoimmune blistering disorders (ABDs) might elevate cardiovascular risk, but studies are lacking. OBJECTIVE The objective of this study was to examine if ABDs elevate the risk of atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death. METHODS A population-based cohort of Danish patients with ABD (≥18 years of age) diagnosed during 1996-2021 (n = 3322) was compared with an age- and sex-matched comparison cohort from the general population (n = 33,195). RESULTS Compared with the general population, patients with ABDs had higher 1-year risks of atherosclerotic cardiovascular disease (3.4% vs 1.6%), heart failure (1.9% vs 0.7%), arrhythmia (3.8% vs 1.3%), venous thromboembolism (1.9% vs 0.3%), and cardiovascular death (3.3% vs 0.9%). The elevated risk persisted after 10 years for all outcomes but arrhythmia. The hazard ratios associating ABDs with the outcomes during the entire follow-up were 1.24 (1.09-1.40) for atherosclerotic cardiovascular disease, 1.48 (1.24-1.77) for heart failure, 1.16 (1.02-1.32) for arrhythmia, 1.87 (1.50-2.34) for venous thromboembolism, and 2.01 (1.76-2.29) for cardiovascular death. The elevated cardiovascular risk was observed for both pemphigus and pemphigoid. LIMITATIONS Our findings might only generalize to patients with ABDs without prevalent cardiovascular diseases. CONCLUSION Patients with ABDs had an elevated cardiovascular risk compared with age- and sex-matched controls.
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Affiliation(s)
- Kasper Bonnesen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Christian F B Poulsen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Cardiology, Gødstrup Regional Hospital, Herning, Denmark; Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Sigrun A J Schmidt
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Morten Schmidt
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Cardiology, Gødstrup Regional Hospital, Herning, Denmark
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2
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Kawamoto H, Saito-Sasaki N, Sakuragi Y, Sawada Y. A Case Report of Mycosis Fungoides Presenting With Blister Formation. Cureus 2024; 16:e54213. [PMID: 38496187 PMCID: PMC10941054 DOI: 10.7759/cureus.54213] [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] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
Mycosis fungoides (MF) is the most common primary cutaneous T-cell lymphoma with a usually indolent course. Early detection is crucial for effective intervention. We present a case of a 40-year-old male with MF exhibiting blistering as a rare precursor symptom. Despite initial treatment for eczema, the condition worsened over 10 months, leading to erythema, edema, and enlarged lymph nodes. Laboratory and imaging findings confirmed the diagnosis of MF. The patient responded partially to cyclophosphamide/doxorubicin/prednisone in combination with brentuximab vedotin (A-CHP) therapy. This case highlights the significance of recognizing blistering as a prodromal symptom for early detection and management of MF.
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Affiliation(s)
- Hirofumi Kawamoto
- Dermatology, University of Occupational and Environmental Health, Kitakyushu, JPN
| | - Natsuko Saito-Sasaki
- Dermatology, University of Occupational and Environmental Health, Kitakyushu, JPN
| | - Yumiko Sakuragi
- Dermatology, University of Occupational and Environmental Health, Kitakyushu, JPN
| | - Yu Sawada
- Dermatology, University of Occupational and Environmental Health, Kitakyushu, JPN
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3
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Liu YA, Chen JG. High-frequency ultrasound: A novel noninvasive tool for evaluation of specific layers of blistering. Exp Dermatol 2023; 32:2173-2175. [PMID: 37462068 DOI: 10.1111/exd.14886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/23/2023] [Accepted: 07/02/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Yang-Ai Liu
- Department of dermatology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Jin-Guang Chen
- Department of dermatology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
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4
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Khan A, Riaz R, Ashraf S, Akilimali A. Revolutionary breakthrough: FDA approves Vyjuvek, the first topical gene therapy for dystrophic epidermolysis bullosa. Ann Med Surg (Lond) 2023; 85:6298-6301. [PMID: 38098548 PMCID: PMC10718329 DOI: 10.1097/ms9.0000000000001422] [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: 06/07/2023] [Accepted: 10/09/2023] [Indexed: 12/17/2023] Open
Abstract
This article provides an updated overview of Vyjuvek, a Food and Drug Administration (FDA) approved medication and its potential in managing dystrophic epidermolysis bullosa (DEB). DEB is a rare genetic disorder characterized by skin fragility, blistering, wounds, and scarring. The underlying cause of DEB is the impaired production of type VII collagen (COL7), leading to weakened anchoring fibrils in the skin. Vyjuvek is the first topical gene therapy for DEB, utilizing a genetically modified HSV-1 (herpes simplex virus 1) vector to express human COL7 and promote wound healing. Clinical trials have shown that Vyjuvek increases the probability of complete wound healing compared to placebo. Although further research is needed, Vyjuvek represents a significant advancement in addressing the unmet medical needs of patients with DEB, offering hope for improved quality of life and long-term complication reduction.
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Affiliation(s)
- Afsheen Khan
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Rumaisa Riaz
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Saad Ashraf
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Aymar Akilimali
- Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of the Congo
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5
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Cernova J, Patel M, Ligaj M, Goldsmith P, Dhoat S, O'Toole E, Atkar R. Large Congenital Cutaneous Mastocytoma Presenting With Recurrent Persistent Blistering: A Case Report. Cureus 2023; 15:e50306. [PMID: 38205464 PMCID: PMC10777259 DOI: 10.7759/cureus.50306] [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] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/12/2024] Open
Abstract
Congenital cutaneous mastocytoma is an uncommon disorder characterized by abnormal proliferation of mast cells. It typically presents as a single, small, yellowish-brown plaque, and its diagnosis is generally facilitated by distinctive clinical features, including a positive Darrier's sign. This report presents a case of an unusually large, solitary congenital mastocytoma encompassing nearly the entire circumference of the calf, observed in a newborn boy of Bangladeshi origin. Measuring 13x6 cm, the lesion formed large bullae and subsequent erosions. The perplexing clinical appearance prompted a skin biopsy, revealing monomorphic CD117 (c-KIT) positive infiltration without significant cell pleomorphism, confirming the diagnosis of cutaneous mastocytoma. The patient underwent management with potent and very potent topical steroids, oral antihistamines, and non-adhesive dressings, remaining under long-term follow-up with secondary care dermatology. In reporting this case, our objective is to augment the existing scientific literature by providing additional evidence that cutaneous mastocytomas can display a spectrum of clinical presentations, as illustrated in this case.
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Affiliation(s)
- Jeva Cernova
- Dermatology, Barts Health NHS Trust, London, GBR
| | | | - Marcin Ligaj
- Histopathology, Barts Health NHS Trust, London, GBR
| | | | - Sasha Dhoat
- Dermatology, Barts Health NHS Trust, London, GBR
| | - Edel O'Toole
- Dermatology, Barts Health NHS Trust, London, GBR
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6
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Hsu E, Kinoshita AT, McCoy CE. Bullous Pemphigoid Causing Successive Emergency Department Visits. Clin Pract Cases Emerg Med 2023; 7:268-270. [PMID: 38353200 PMCID: PMC10855292 DOI: 10.5811/cpcem.1415] [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] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/01/2023] [Accepted: 08/21/2023] [Indexed: 02/18/2024] Open
Abstract
Case Presentation In this case presentation, an 84-year-old male with Fitzpatrick type IV skin tone experienced blistering due to bullous pemphigoid (BP), first on the distal upper left extremity and then on the distal lower extremities, chest, and back. These symptoms resulted in three visits to the emergency department within a month, as well as an episode of hospitalization. Despite treatment, the blistering did not resolve until future outpatient care with dermatology. Discussion Bullous pemphigoid is a rare autoimmune disease where autoantibodies target hemidesmosomal proteins causing basement membrane destruction and tense subepithelial bullae with pruritus. While uncommon, the incidence of BP is increasing. Bullous pemphigoid tends to affect older adults, appearing as a rash prior to bullae formation on the abdomen, extremities, groin, axillae, or mucosa. Bullous pemphigoid may also be drug-related with atypical symptoms. Diagnosis of BP should be based on immunopathology, and initial treatment of BP is through corticosteroid or doxycycline.
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Affiliation(s)
- Edmund Hsu
- University of California Irvine, Department of Emergency Medicine, Orange, California
| | | | - C. Eric McCoy
- University of California Irvine, Department of Emergency Medicine, Orange, California
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7
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Lai J, Lu I. Angina bullosa haemorrhagica: Accelerated healing following kiwi consumption. JAAD Case Rep 2023; 38:86-88. [PMID: 37484654 PMCID: PMC10362006 DOI: 10.1016/j.jdcr.2023.06.007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Affiliation(s)
- Jonathan Lai
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Irene Lu
- Department of Dermatology, North Shore University Hospital, Manhasset, New York
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8
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Araiza JDJ, Álvarez-Fraga L, Gago R, Sánchez O. Surface Morphology and Optical Properties of Hafnium Oxide Thin Films Produced by Magnetron Sputtering. Materials (Basel) 2023; 16:5331. [PMID: 37570035 PMCID: PMC10419556 DOI: 10.3390/ma16155331] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
Hafnium oxide films were deposited on sapphire and silicon (100) substrates using the DC reactive magnetron sputtering technique from a pure hafnium target at different discharge power levels. The influence of the cathode power on the chemical composition, morphology, crystallographic structure and optical properties of the films was investigated. X-ray diffraction (XRD), energy dispersive X-ray analysis (EDX) and Fourier-transform infrared spectroscopy (FTIR) were employed to determine the chemical composition and bonding structure. In all cases, the films were found to be amorphous or nanocrystalline with increased crystalline content as the sputtering power was increased, according to XRD and FTIR. In addition, EDX showed that the films were oxygen-rich. The effect of power deposition on the surface topography and morphology of the films was studied using atomic force microscopy (AFM) and scanning electron microscopy (SEM). The AFM and SEM images revealed the emergence of mound morphologies as the cathode power was increased. These features are related to blistering effects probably due to the presence of stress and its promotion within the film thickness. Finally, the optical properties showed an average transmission of 80% in the visible range, and the refractive index determined by spectral ellipsometry (SE) was found to be in the range of 1.85-1.92, close to the reported bulk value. SE was also used to study the film porosity observed by SEM, which can be related to the oxygen-rich character of the films.
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Affiliation(s)
- José de Jesús Araiza
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Cantoblanco, 28049 Madrid, Spain; (J.d.J.A.); (L.Á.-F.); (R.G.)
- Unidad Académica de Física, Universidad Autónoma de Zacatecas, Calzada Solidaridad Esq, Paseo La Bufa, Fracc, Progreso, Zacatecas 98060, Mexico
| | - Leo Álvarez-Fraga
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Cantoblanco, 28049 Madrid, Spain; (J.d.J.A.); (L.Á.-F.); (R.G.)
| | - Raúl Gago
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Cantoblanco, 28049 Madrid, Spain; (J.d.J.A.); (L.Á.-F.); (R.G.)
| | - Olga Sánchez
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Cantoblanco, 28049 Madrid, Spain; (J.d.J.A.); (L.Á.-F.); (R.G.)
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9
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Hou PC, del Agua N, Lwin SM, Hsu CK, McGrath JA. Innovations in the Treatment of Dystrophic Epidermolysis Bullosa (DEB): Current Landscape and Prospects. Ther Clin Risk Manag 2023; 19:455-473. [PMID: 37337559 PMCID: PMC10277004 DOI: 10.2147/tcrm.s386923] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 04/26/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023] Open
Abstract
Dystrophic epidermolysis bullosa (DEB) is one of the major types of EB, a rare hereditary group of trauma-induced blistering skin disorders. DEB is caused by inherited pathogenic variants in the COL7A1 gene, which encodes type VII collagen, the major component of anchoring fibrils which maintain adhesion between the outer epidermis and underlying dermis. DEB can be subclassified into dominant (DDEB) and recessive (RDEB) forms. Generally, DDEB has a milder phenotype, while RDEB patients often have more extensive blistering, chronic inflammation, skin fibrosis, and a propensity for squamous cell carcinoma development, collectively impacting on daily activities and life expectancy. At present, best practice treatments are mostly supportive, and thus there is a considerable burden of disease with unmet therapeutic need. Over the last 20 years, considerable translational research efforts have focused on either trying to cure DEB by direct correction of the COL7A1 gene pathology, or by modifying secondary inflammation to lessen phenotypic severity and improve patient symptoms such as poor wound healing, itch, and pain. In this review, we provide an overview and update on various therapeutic innovations for DEB, including gene therapy, cell-based therapy, protein therapy, and disease-modifying and symptomatic control agents. We outline the progress and challenges for each treatment modality and identify likely prospects for future clinical impact.
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Affiliation(s)
- Ping-Chen Hou
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nathalie del Agua
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - Su M Lwin
- St John’s Institute of Dermatology, School of Basic and Medical Biosciences, King’s College London, London, UK
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
| | - John A McGrath
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- International Center for Wound Repair and Regeneration (iWRR), National Cheng Kung University, Tainan, Taiwan
- St John’s Institute of Dermatology, School of Basic and Medical Biosciences, King’s College London, London, UK
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Gong Y, Mao J, Liu M, Gao J. A case of toxic epidermal necrolysis associated with lenvatinib and sintilimab therapy for intrahepatic cholangiocarcinoma. J Int Med Res 2023; 51:3000605231173556. [PMID: 37211771 DOI: 10.1177/03000605231173556] [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: 05/23/2023] Open
Abstract
Lenvatinib is used as the first-line treatment for intrahepatic cholangiocarcinoma. Sintilimab is a programmed cell death receptor-1 (PD-1) antibody used in the treatment of solid tumors. We present the case of a 78-year-old man with fatal toxic epidermal necrolysis (TEN) associated with the use of sintilimab followed by lenvatinib. This patient, who presented with intrahepatic cholangiocarcinoma, first received immunotherapy with sintilimab according to the standard schedule of 200 mg every 3 weeks. The patient began to receive 8 mg of lenvatinib daily 1 day after sintilimab therapy was initiated. Multiple erythematous papules and blisters appeared on the patient's face and trunk and gradually spread to his arms and legs, and the lesions extensively involved >30% of the body surface area 18 days after lenvatinib initiation. The patient stopped taking lenvatinib on the next day. The skin rash quickly progressed over 1 week to a tender, exfoliative dermatosis. Despite treatment with high-dose steroids and intravenous immunoglobulin, the patient died. To the best of our knowledge, this is the first case of TEN associated with the use of sintilimab followed by lenvatinib. Early diagnosis and treatment of possibly fatal TEN reaction secondary to anti-PD-1 antibody therapy followed by lenvatinib is necessary.
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Affiliation(s)
- Yinhua Gong
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Jinzhu Mao
- Department of Dermatology, the First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Ming Liu
- Department of Dermatology, the First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Jie Gao
- Department of Pharmacy, the First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
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11
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Rossi L, Tiecco G, Venturini M, Castelli F, Quiros-Roldan E. Human Orf with Immune-Mediated Reactions: A Systematic Review. Microorganisms 2023; 11:1138. [PMID: 37317112 DOI: 10.3390/microorganisms11051138] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 03/11/2023] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 06/16/2023] Open
Abstract
Background: Orf is a highly contagious zoonosis caused by Orf virus (ORFV), which is endemic in sheep and goats worldwide. Human Orf is usually a self-limiting disease, but potential complications, including immune-mediated reactions, may occur. Methods: We included all articles regarding Orf-associated immunological complications published in peer-reviewed medical journals. We conducted a literature search of the United States National Library of Medicine, PubMed, MEDLINE, PubMed Central, PMC, and the Cochrane Controlled Trials. Results: A total of 16 articles and 44 patients were included, prevalently Caucasian (22, 95.7%) and female (22, 57.9%). The prevailing immunological reaction was erythema multiforme (26, 59.1%), followed by bullous pemphigoid (7, 15.9%). In most cases, the diagnosis was made on the basis of clinical and epidemiological history (29, 65.9%), while a biopsy of secondary lesions was performed in 15 patients (34.1%). A total of 12 (27.3%) patients received a local or systemic treatment for primary lesions. Surgical removal of primary lesion was described in two cases (4.5%). Orf-immune-mediated reactions were treated in 22 cases (50.0%), mostly with topical corticosteroids (12, 70.6%). Clinical improvement was reported for all cases. Conclusions: Orf-related immune reactions can have a varied clinical presentation, and it is important for clinicians to be aware of this in order to make a prompt diagnosis. The main highlight of our work is the presentation of complicated Orf from an infectious diseases specialist's point of view. A better understanding of the disease and its complications is essential to achieve the correct management of cases.
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Affiliation(s)
- Luca Rossi
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Giorgio Tiecco
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Marina Venturini
- Department of Clinical and Experimental Sciences, Section of Dermatology, University of Brescia, 25123 Brescia, Italy
| | - Francesco Castelli
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Eugenia Quiros-Roldan
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
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12
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Coelho KF, Neves JCF, Ibiapina HNS, Magalhães-Gama F, Barbosa FBA, Silva FS, Wellmann IAM, Sachett JAG, Tarragô AM, Ferreira LCL, Malheiro A, Monteiro WM, Costa AG. Exploring the Profile of Cell Populations and Soluble Immunological Mediators in Bothrops atrox Envenomations. Toxins (Basel) 2023; 15:196. [PMID: 36977086 PMCID: PMC10051854 DOI: 10.3390/toxins15030196] [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: 01/27/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
Bothrops atrox envenomations are common in the Brazilian Amazon. The venom of B. atrox is highly inflammatory, which results in severe local complications, including the formation of blisters. Moreover, there is little information on the immune mechanisms associated with this condition. Thus, a longitudinal study was carried out to characterize the profile of the cell populations and soluble immunological mediators in the peripheral blood and blisters in B. atrox patients s according to their clinical manifestations (mild and severe). A similar response in both B. atrox patient groups (MILD and SEV) was observed, with an increase in inflammatory monocytes, NKT, and T and B cells, as well as CCL2, CCL5, CXCL9, CXCL10, IL-1β and IL-10, when compared with the group of healthy blood donors. After the administration of antivenom, the participation of patrolling monocytes and IL-10 in the MILD group was observed. In the SEV group, the participation of B cells was observed, with high levels of CCL2 and IL-6. In the blister exudate, a hyperinflammatory profile was observed. In conclusion, we revealed the involvement of cell populations and soluble mediators in the immune response to B. atrox envenomation at the local and peripheral level, which is related to the onset and extent of the inflammation/clinical manifestation.
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Affiliation(s)
- Kerolaine Fonseca Coelho
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
| | - Juliana Costa Ferreira Neves
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
| | - Hiochelson Najibe Santos Ibiapina
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
| | - Fábio Magalhães-Gama
- Programa de Pós-Graduação em Ciências da Saúde, Instituto René Rachou-Fundação Oswaldo Cruz (FIOCRUZ Minas), Belo Horizonte 30190-002, MG, Brazil
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus 69050-001, AM, Brazil
| | - Fabiane Bianca Albuquerque Barbosa
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
| | - Flavio Souza Silva
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus 69050-001, AM, Brazil
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Universidade Federal do Amazonas (UFAM), Manaus 69067-005, AM, Brazil
| | - Irmgardt Alicia María Wellmann
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
| | - Jacqueline Almeida Gonçalves Sachett
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
- Departamento de Ensino e Pesquisa, Fundação Alfredo da Matta (FUAM), Manaus 69065-130, AM, Brazil
| | - Andréa Monteiro Tarragô
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus 69050-001, AM, Brazil
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Universidade Federal do Amazonas (UFAM), Manaus 69067-005, AM, Brazil
- Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Universidade do Estado do Amazonas (UEA), Manaus 69050-001, AM, Brazil
| | - Luiz Carlos Lima Ferreira
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
| | - Adriana Malheiro
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus 69050-001, AM, Brazil
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Universidade Federal do Amazonas (UFAM), Manaus 69067-005, AM, Brazil
- Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Universidade do Estado do Amazonas (UEA), Manaus 69050-001, AM, Brazil
| | - Wuelton Marcelo Monteiro
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
| | - Allyson Guimarães Costa
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus 69040-000, AM, Brazil
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus 69040-000, AM, Brazil
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus 69050-001, AM, Brazil
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Universidade Federal do Amazonas (UFAM), Manaus 69067-005, AM, Brazil
- Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Universidade do Estado do Amazonas (UEA), Manaus 69050-001, AM, Brazil
- Escola de Enfermagem de Manaus, Universidade Federal do Amazonas (UFAM), Manaus 69057-070, AM, Brazil
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13
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Ng JKM, Cheung CMT, Choi PCL, Ip ECC, Li JJX, Chan AWS. A rare presentation of pemphigus vegetans as an isolated vegetative lesion-Review of histopathological clues and treatment effects in multiple biopsy specimens. J Cutan Pathol 2023; 50:201-208. [PMID: 36502456 DOI: 10.1111/cup.14375] [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: 08/24/2022] [Revised: 11/26/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pemphigus is a group of immunobullous dermatoses characterized by the presence of autoantibodies directed against adhesion molecules of keratinocytes, with pemphigus vegetans being the rarest form, accounting for 1%-2% of all cases of pemphigus. Pemphigus vegetans is characterized by verrucous vegetative lesions in addition to vesiculobullous lesions. METHODS We report a rare case of pemphigus vegetans presenting as an isolated vegetative lesion in the groin 3 months prior to the development of blisters. Owing to the atypical presentation, multiple biopsies were performed before and after corticosteroid treatment. RESULTS Comparing the histopathology of pre-treatment and post-treatment biopsy specimens, the resolution of intraepidermal microabscesses, and reduction in intraepidermal and dermal inflammatory infiltrates, spongiosis and interface change, attributable to treatment, were noted. However, direct immunofluorescence showed persistent intracellular intraepidermal deposition of IgG and C3 2 weeks into treatment, despite near-complete resolution of blisters on clinical examination. Clinical regression of the vegetative lesion was noted only after 6 weeks into corticosteroid treatment, while histopathological evidence of treatment was apparent at the second week. CONCLUSION The current case illustrates the importance of a liberal use of immunofluorescence studies in establishing the uncommon yet significant diagnosis of pemphigus vegetans, particularly for vegetative lesions that are persistent, in the intertriginous areas and/or in the setting of concurrent cutaneous or mucosal symptoms.
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Affiliation(s)
- Joanna Ka Man Ng
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Christina Man-Tung Cheung
- Department of Medicine and Therapeutics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Paul Cheung Lung Choi
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Edric Chi-Ching Ip
- Department of Medicine and Therapeutics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Joshua Jing Xi Li
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Agnes Wai Sze Chan
- Department of Medicine and Therapeutics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
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14
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Li H, Huang R, Liao Y, Yang S, Feng B, Qin H, Zhou J, Zeng Y, Shen J, Zhuang X, Jiang L, Otegui MS, Zhang S, Gao C. A plant-unique protein BLISTER coordinates with core retromer to modulate endosomal sorting of plasma membrane and vacuolar proteins. Proc Natl Acad Sci U S A 2023; 120:e2211258120. [PMID: 36577063 DOI: 10.1073/pnas.2211258120] [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] [Indexed: 12/29/2022] Open
Abstract
The retromer is a heteromeric protein complex that localizes to endosomal membranes and drives the formation of endosomal tubules that recycle membrane protein cargoes. In plants, the retromer plays essential and canonical functions in regulating the transport of vacuolar storage proteins and the recycle of endocytosed plasma membrane proteins (PM); however, the mechanisms underlying the regulation of assembly, protein stability, and membrane recruitment of the plant retromer complex remain to be elucidated. In this study, we identify a plant-unique endosomal regulator termed BLISTER (BLI), which colocalizes and associates with the retromer complex by interacting with the retromer core subunits VPS35 and VPS29. Depletion of BLI perturbs the assembly and membrane recruitment of the retromer core VPS26-VPS35-VPS29 trimer. Consequently, depletion of BLI disrupts retromer-regulated endosomal trafficking function, including transport of soluble vacuolar proteins and recycling of endocytosed PIN-FORMED (PIN) proteins from the endosomes back to the PM. Moreover, genetic analysis in Arabidopsis thaliana mutants reveals BLI and core retromer interact genetically in the regulation of endosomal trafficking. Taken together, we identified BLI as a plant-specific endosomal regulator, which functions in retromer pathway to modulate the recycling of endocytosed PM proteins and the trafficking of soluble vacuolar cargoes.
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15
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El-Hamdi NS, Dacy NN, Brown SC, Fernandez MP. Cutaneous presentation of bullous multisystem inflammatory syndrome in a child: A diagnosis not to "MIS-C". Pediatr Dermatol 2023; 40:571-572. [PMID: 36593226 DOI: 10.1111/pde.15233] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 09/01/2022] [Accepted: 12/12/2022] [Indexed: 01/04/2023]
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious inflammatory response associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Mucocutaneous findings are often present but remain poorly defined overall, and more precise dermatologic descriptions are not only necessary to better characterize this syndrome, but may also aid in early diagnosis and prevention of severe deterioration or death. We report the case of a 16-month-old boy presenting with a diffuse maculopapular eruption, cheilitis, and vesiculobullous lesions of the scrotum, perianal region, and distal lower extremities. Tense bullae of the genitals and lower extremities have not been previously reported in MIS-C and add to the spectrum of skin findings associated with the disorder.
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Affiliation(s)
| | - Nicole N Dacy
- Baylor Scott & White Dermatology, Temple, Texas, USA
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16
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Yang J, Hu X, Niu M, Zheng X. Prurigo Pigmentosa Successfully Treated with Oral Minocycline: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:1073-1077. [PMID: 37123623 PMCID: PMC10145459 DOI: 10.2147/ccid.s404859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/04/2023] [Indexed: 05/02/2023]
Abstract
Purpose We aimed to report a case of prurigo pigmentosa (PP) with blisters. Patients and Methods A 21-year-old male patient presented to our hospital with erythema, papules, and blisters all over the front chest and back. Densely distributed round and oval edematous erythema was noted on the neck, front chest, and back of the patient. Histopathologic examination of the skin lesions (blisters) on the chest revealed epidermal cell hyperkeratosis. He was diagnosed with PP and was treated with oral minocycline. Results After 1-week minocycline administration, the patient's itching was relieved, and the blisters dried up. His skin lesions recurred following self-withdrawal from the medication; subsequently, the patient was administered oral minocycline treatment again. After 1-month continuous oral treatment, the drug was discontinued. No recurrence of symptoms was noted. Conclusion Oral minocycline is effective for the treatment of PP.
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Affiliation(s)
- Jie Yang
- Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China
| | - Xiaohuan Hu
- Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China
| | - Mu Niu
- Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China
- Correspondence: Mu Niu; Xiaole Zheng, Department of Dermatology, The Fifth People’s Hospital of Hainan Province, No. 8 Longhua Road, Longhua District, Haikou City, Hainan Province, 570206, People’s Republic of China, Email ;
| | - Xiaole Zheng
- Department of Dermatology, The Fifth People’s Hospital of Hainan Province, Haikou, Hainan Province, People’s Republic of China
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17
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Barnes P, Gonzales J, Hammond D. Chromobacterium violaceum: A rare opportunistic pathogen and clue for pediatric chronic granulomatous disease. Pediatr Dermatol 2022; 40:396-397. [PMID: 36480441 DOI: 10.1111/pde.15215] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/15/2022] [Indexed: 12/13/2022]
Abstract
Chromobacterium violaceum is a rare bacterium found in water and soil in tropical regions and typically presents with a localized skin infection or lymphadenitis which can progress to fulminant septicemia and even death. We describe a case of a 2-year-old boy with C. violaceum septicemia from a suspected skin source which was confirmed by wound, tissue and blood cultures. The discovery of this rare organism, subsequently led to the evaluation and identification of underlying chronic granulomatous disease.
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Affiliation(s)
- Peter Barnes
- Department of Dermatology, Keesler Air Force Base Medical Center, Biloxi, Mississippi, USA
| | - Jesse Gonzales
- Department of Dermatology, Keesler Air Force Base Medical Center, Biloxi, Mississippi, USA
| | - Daniel Hammond
- Department of Pediatrics, Keesler Air Force Base Medical Center, Biloxi, Mississippi, USA
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18
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Grillo VTRDS, Botelho MS, Lange EP, Secanho MS, de Camargo PAB, Miot HA. Bullosis diabeticorum as a differential diagnosis for limb ulcers: case report. J Vasc Bras 2022; 21:e20210190. [PMID: 36187219 PMCID: PMC9477478 DOI: 10.1590/1677-5449.202101901] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
Bullosis diabeticorum (BD) is an uncommon cutaneous manifestation of diabetes that can affect the upper limbs. It is characterized by spontaneous and painless non-inflammatory bloody blisters, which can progress to necrosis, requiring differential diagnosis to rule out other dermatological diseases, such as porphyria cutanea tarda, pseudoporphyria, epidermolysis bullosa acquisita, and pemphigoid, and vascular diseases, such as vasculitis, peripheral arterial disease, and Buerger's disease, among others. In this report, we describe a 77-year-old male patient with poorly controlled diabetes and hypertension who presented with spontaneous onset of lesions on the upper limbs, initially with bullous characteristics, progressing to necrotic ulcers after spontaneous rupture. A biopsy revealed hyaline thickening of the dermal vessels and subcorneal bullae, consistent with a diagnosis of BD. After smoking cessation and optimization of glycemia control combined with topical corticosteroid therapy, the condition improved and lesions began to heal. This presentation of BD involving the upper limbs is rare, requiring differential diagnosis to rule out other cutaneous and vascular lesions.
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Affiliation(s)
| | - Mayra Souza Botelho
- Universidade Estadual Paulista Júlio de Mesquita Filho – UNESP, Faculdade de Medicina, Campus de Botucatu, Botucatu, SP, Brasil.
| | - Eloana Pasqualin Lange
- Universidade Estadual Paulista Júlio de Mesquita Filho – UNESP, Faculdade de Medicina, Campus de Botucatu, Botucatu, SP, Brasil.
| | - Murilo Sgarbi Secanho
- Universidade Estadual Paulista Júlio de Mesquita Filho – UNESP, Faculdade de Medicina, Campus de Botucatu, Botucatu, SP, Brasil.
| | - Paula Angeleli Bueno de Camargo
- Universidade Estadual Paulista Júlio de Mesquita Filho – UNESP, Faculdade de Medicina, Campus de Botucatu, Botucatu, SP, Brasil.
| | - Hélio Amante Miot
- Universidade Estadual Paulista Júlio de Mesquita Filho – UNESP, Faculdade de Medicina, Campus de Botucatu, Botucatu, SP, Brasil.
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19
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Etesami I, Dadkhahfar S, Kalantari Y. Topical care in pemphigus wounds: A systematic review of the literature. Dermatol Ther 2022; 35:e15808. [PMID: 36070217 DOI: 10.1111/dth.15808] [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: 06/09/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
Pemphigus is a group of autoimmune blistering diseases. Given the ulcerative nature of the diseases, the full healing of ulcers and erosions might be challenging. The aim of this study was to determine various topical wound care options for pemphigus patients, the advantage of each alternative, and to compare their efficacy, safety, and feasibility. In accordance with PRISMA guideline, we performed a systematic search in PubMed/Medline, web of science, and Scopus databases for articles published from inception until 2/20/2022. Out of 703 initially retrieved articles, 11 full texts were included. Our findings were divided into the following categories: silver-containing dressings, paraffin-embedded tulle nets, topical insulin, EPIFIBROIN 0039, platelet gel, and Biobrane®. The most commonly used topical care in pemphigus patients was silver-containing dressings in six studies. All of the included studies reported acceptable outcomes without any severe adverse effects. Due to the few available studies in this field, a definite suggestion cannot be made. We recommend larger randomized controlled studies to identify the best topical care modality in pemphigus patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ifa Etesami
- Department of Dermatology, Razi Hospital, Tehran University of medical sciences, Tehran, Iran
| | - Sahar Dadkhahfar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yasamin Kalantari
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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20
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Mukherjee EM, Phillips EJ. Where to place etanercept and combination treatment for Stevens-Johnson syndrome and toxic epidermal necrolysis? Ann Allergy Asthma Immunol 2022; 129:269-270. [PMID: 35988972 PMCID: PMC9931047 DOI: 10.1016/j.anai.2022.06.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 02/01/2023]
Affiliation(s)
- Eric M Mukherjee
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Drug Safety and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Elizabeth J Phillips
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Drug Safety and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Centre for Clinical Pharmacology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia.
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21
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Nguyen SM, Lee M, Lin W, Ngo JV, Dhillon I. Blisters in a 7-year-old girl with atopic dermatitis. Pediatr Dermatol 2022; 39:811-812. [PMID: 35830353 DOI: 10.1111/pde.15039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/08/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Sang M Nguyen
- Department of Pediatrics, University of California at San Francisco, San Francisco, California, USA
| | - Michelle Lee
- Department of Pediatrics, University of California at San Francisco, San Francisco, California, USA
| | - Walter Lin
- The Buncke Clinic, San Francisco, California, USA.,Saint Francis Memorial Hospital, San Francisco, California, USA
| | - Justine V Ngo
- Department of Pediatrics, Kaiser Permanente, San Francisco, California, USA
| | - Inder Dhillon
- Department of Dermatology, Kaiser Permanente, San Francisco, California, USA
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22
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Kim SY, Kim SH, Son DH, Yoo H, Kim S, Kim S, Kim YI, Park SN, Jeon DH, Lee J, Jo HJ, Sung SJ, Hwang DK, Yang KJ, Kim DH, Kang JK. Effect of Metal-Precursor Stacking Order on Volume-Defect Formation in CZTSSe Thin Film: Formation Mechanism of Blisters and Nanopores. ACS Appl Mater Interfaces 2022; 14:30649-30657. [PMID: 35708228 DOI: 10.1021/acsami.2c01892] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In this study, we investigated the effect of the stacking order of metal precursors on the formation of volume defects, such as blisters and nanopores, in CZTSSe thin-film solar cells. We fabricated CZTSSe thin films using three types of metal-precursor combinations, namely, Zn/Cu/Sn/Mo, Cu/Zn/Sn/Mo, and Sn/Cu/Zn/Mo, and studied the blister formation. The blister-formation mechanism was based on the delamination model, taking into consideration the compressive stress and adhesion properties. A compressive stress could be induced during the preferential formation of a ZnSSe shell. Under this stress, the adhesion between the ZnSSe film and the Mo substrate could be maintained by the surface tension of a metallic liquid phase with good wettability, or by the functioning of ZnSSe pillars as anchors, depending on the type of metal precursor used. Additionally, the nanopore formation near the back-contact side was found to be induced by the columnar microstructure of the metal precursor with the Cu/Zn/Mo stacking order and its dezincification. Based on the two volume-defect-formation mechanisms proposed herein, further development of volume-defect-formation suppression technology is expected to be made.
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Affiliation(s)
- Se-Yun Kim
- Department of Advanced Materials Science and Engineering, Kyungnam University, Changwon 51767, Republic of Korea
| | - Seung-Hyun Kim
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Dae-Ho Son
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Hyesun Yoo
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Seongyeon Kim
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Sammi Kim
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Young-Ill Kim
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Si-Nae Park
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Dong-Hwan Jeon
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Jaebaek Lee
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Hyo-Jeong Jo
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Shi-Joon Sung
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Dae-Kue Hwang
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Kee-Jeong Yang
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Dae-Hwan Kim
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
| | - Jin-Kyu Kang
- Research Center for Thin Film Solar Cells, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
- Division of Energy Technology, Daegu-Gyeongbuk Institute of Science and Technology (DGIST), Daegu 42988, Republic of Korea
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23
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Choi BL, Jung JK, Baek UB, Choi BH. Effect of Functional Fillers on Tribological Characteristics of Acrylonitrile Butadiene Rubber after High-Pressure Hydrogen Exposures. Polymers (Basel) 2022; 14:861. [PMID: 35267684 DOI: 10.3390/polym14050861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/17/2021] [Revised: 02/11/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
In a high-pressure hydrogen environment, the sealing rubber material is swelled by hydrogen, and the mechanical and tribological properties are reduced, causing various problems in the sealing performance. The focus of this study was the effect of the filler type and content on the tribological characteristics of rubber after exposure to high-pressure hydrogen. Acrylonitrile butadiene rubber specimens were exposed to high-pressure hydrogen at 96.6 MPa, and the change in the amount of wear with time after exposure was observed. The wear test was performed using a pin-on-disc ball tip to measure the amount of wear before and after hydrogen exposure of the materials under fixed revolutions per minute and normal load. Scanning electron microscopy was used to observe the wear track and cross section of the specimen to examine the changes in the wear mechanism after hydrogen exposure and to analyze the wear mechanism for each filler. The results of this study are expected to contribute to the evaluation of the tribological properties of the sealing materials used in hydrogen environments.
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24
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Lim JH, Hou J, Lee CH. Dynamic Mechanical Fatigue Behavior of Polymer Electrolyte Membranes for Fuel Cell Electric Vehicles Using a Gas Pressure-Loaded Blister. Polymers (Basel) 2021; 13:4177. [PMID: 34883680 DOI: 10.3390/polym13234177] [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: 11/09/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022] Open
Abstract
This study reports on an innovative press-loaded blister hybrid system equipped with gas-chromatography (PBS-GC) that is designed to evaluate the mechanical fatigue of two representative types of commercial Nafion membranes under relevant PEMFC operating conditions (e.g., simultaneously controlling temperature and humidity). The influences of various applied pressures (50 kPa, 100 kPa, etc.) and blistering gas types (hydrogen, oxygen, etc.) on the mechanical resistance loss are systematically investigated. The results evidently indicate that hydrogen gas is a more effective blistering gas for inducing dynamic mechanical losses of PEM. The changes in proton conductivity are also measured before and after hydrogen gas pressure-loaded blistering. After performing the mechanical aging test, a decrease in proton conductivity was confirmed, which was also interpreted using small angle X-ray scattering (SAXS) analysis. Finally, an accelerated dynamic mechanical aging test is performed using the homemade PBS-GC system, where the hydrogen permeability rate increases significantly when the membrane is pressure-loaded blistering for 10 min, suggesting notable mechanical fatigue of the PEM. In summary, this PBS-GC system developed in-house clearly demonstrates its capability of screening and characterizing various membrane candidates in a relatively short period of time (<1.5 h at 50 kPa versus 200 h).
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Gimenes SNC, Sachett JAG, Colombini M, Freitas-de-Sousa LA, Ibiapina HNS, Costa AG, Santana MF, Park JJ, Sherman NE, Ferreira LCL, Wen FH, Monteiro WM, Moura-da-Silva AM, Fox JW. Observation of Bothrops atrox Snake Envenoming Blister Formation from Five Patients: Pathophysiological Insights. Toxins (Basel) 2021; 13:toxins13110800. [PMID: 34822585 PMCID: PMC8618272 DOI: 10.3390/toxins13110800] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Received: 10/07/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
In the Brazilian Amazon, Bothrops atrox snakebites are frequent, and patients develop tissue damage with blisters sometimes observed in the proximity of the wound. Antivenoms do not seem to impact blister formation, raising questions regarding the mechanisms underlying blister formation. Here, we launched a clinical and laboratory-based study including five patients who followed and were treated by the standard clinical protocols. Blister fluids were collected for proteomic analyses and molecular assessment of the presence of venom and antivenom. Although this was a small patient sample, there appeared to be a correlation between the time of blister appearance (shorter) and the amount of venom present in the serum (higher). Of particular interest was the biochemical identification of both venom and antivenom in all blister fluids. From the proteomic analysis of the blister fluids, all were observed to be a rich source of damage-associated molecular patterns (DAMPs), immunomodulators, and matrix metalloproteinase-9 (MMP-9), suggesting that the mechanisms by which blisters are formed includes the toxins very early in envenomation and continue even after antivenom treatment, due to the pro-inflammatory molecules generated by the toxins in the first moments after envenomings, indicating the need for local treatments with anti-inflammatory drugs plus toxin inhibitors to prevent the severity of the wounds.
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Affiliation(s)
- Sarah N. C. Gimenes
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (S.N.C.G.); (M.C.); (L.A.F.-d.-S.)
| | - Jacqueline A. G. Sachett
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Dermatologia Alfredo da Matta, Manaus 69065-130, AM, Brazil
| | - Mônica Colombini
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (S.N.C.G.); (M.C.); (L.A.F.-d.-S.)
| | - Luciana A. Freitas-de-Sousa
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (S.N.C.G.); (M.C.); (L.A.F.-d.-S.)
| | - Hiochelson N. S. Ibiapina
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
| | - Allyson G. Costa
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Hematologia e Hemoterapia do Amazonas, Manaus 69040-010, AM, Brazil
| | - Monique F. Santana
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
- Departamento de Ensino e Pesquisa, Fundação de Hematologia e Hemoterapia do Amazonas, Manaus 69040-010, AM, Brazil
| | - Jeong-Jin Park
- School of Medicine, University of Virginia, Charlottesville, VA 22903, USA; (J.-J.P.); (N.E.S.)
| | - Nicholas E. Sherman
- School of Medicine, University of Virginia, Charlottesville, VA 22903, USA; (J.-J.P.); (N.E.S.)
| | - Luiz C. L. Ferreira
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
| | - Fan H. Wen
- Núcleo de Produção de Soros, Instituto Butantan, São Paulo 05503-900, SP, Brazil;
| | - Wuelton M. Monteiro
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus 69050-030, AM, Brazil; (J.A.G.S.); (H.N.S.I.); (A.G.C.); (M.F.S.); (W.M.M.)
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
| | - Ana M. Moura-da-Silva
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil; (S.N.C.G.); (M.C.); (L.A.F.-d.-S.)
- Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus 69040-000, AM, Brazil;
- Correspondence: (A.M.M.-d.-S.); (J.W.F.)
| | - Jay W. Fox
- School of Medicine, University of Virginia, Charlottesville, VA 22903, USA; (J.-J.P.); (N.E.S.)
- Correspondence: (A.M.M.-d.-S.); (J.W.F.)
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Gatica-Ortega ME, Sánchez-Matas I, Gargallo-Quintero AB, Pastor-Nieto MA. Bullous delayed-pressure urticaria masquerading as safety footwear contact dermatitis. Contact Dermatitis 2021; 85:708-710. [PMID: 34293197 DOI: 10.1111/cod.13947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/27/2021] [Accepted: 07/19/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - María A Pastor-Nieto
- Dermatology Department, University Hospital of Guadalajara, Guadalajara, Spain.,Faculty of Medicine and Health Sciences, Medicine and Medical Specialties Department, Universidad de Alcalá, Alcalá de Henares, Spain
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Aghighi M, Smoller BR. Weak immunohistochemical expression of galectin-3 near blisters in Hailey-Hailey disease. J Cutan Pathol 2021; 49:29-33. [PMID: 34272745 DOI: 10.1111/cup.14102] [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: 03/08/2021] [Revised: 05/22/2021] [Accepted: 07/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hailey-Hailey disease (HHD) is an uncommon hereditary and benign skin condition characterized by blisters and erosions on intertriginous areas. It is related to a mutation of the ATP2C1 gene, which encodes a Ca2+ pump. It is characterized by multiple foci of skin acantholysis in the epidermis, with dyskeratosis and suprabasilar clefting. Galectin-3 is a beta-galactoside-binding protein that has an essential role in cell-to-cell and cell-to-matrix adhesion. We assessed galectin-3 immunohistochemical expression in HHD to explore its impact on the pathogenesis of this hereditary blistering disorder. METHOD In a retrospective study, seven specimens from seven patients diagnosed with HHD were stained with antibodies to galectin-3. We evaluated the nuclear and cytoplasmic expression of galectin-3, as well as the staining intensity around blisters and distant normal skin. RESULTS We observed a significant decrease in cytoplasmic and nuclear expression of galectin-3 as well as stain intensity around blisters compared with distant normal skin. CONCLUSIONS While the acantholysis process in HHD is related to abnormality in cadherin expression caused by altered Ca2+ pump concentration, lower expression of galectin-3 may cause the extension of blisters by initiating cell-to-cell disassembly in the epidermis.
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Affiliation(s)
- Maryam Aghighi
- Department of Pathology, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Bruce R Smoller
- Department of Pathology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
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Kuo FC, Hsu CW, Tan TL, Lin PY, Tu YK, Chen PC. Effectiveness of Different Wound Dressings in the Reduction of Blisters and Periprosthetic Joint Infection After Total Joint Arthroplasty: A Systematic Review and Network Meta-Analysis. J Arthroplasty 2021; 36:2612-2629. [PMID: 33707123 DOI: 10.1016/j.arth.2021.02.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 10/10/2020] [Revised: 01/19/2021] [Accepted: 02/16/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The optimal type of dressing in the setting of total joint arthroplasty (TJA) remains uncertain. The aim of this network meta-analysis was to compare various wound dressings and identify the optimal type of dressings for blister reduction and prevention of periprosthetic joint infection (PJI) in patients after TJA. METHODS Studies comparing 2 or more dressing groups after TJA (hip or knee) were systematically searched on PubMed, Embase, and Scopus. Two authors performed the study selection, risk of bias assessment, and data extraction. Both outcomes were assessed using odds ratios (OR) with 95% confidence intervals (CI) and were ranked using surface under the cumulative ranking curve (SUCRA) probabilities to determine a hierarchy of dressings. A sensitivity analysis was performed to reduce the effect of intransitivity between studies. RESULTS A total of 21 studies, consisting of 12 dressing types in 7293 TJAs, were included in the final analysis. The highest incidence of blisters occurred when using negative-pressure wound therapy (OR 9.33, 95% CI 3.51-24.83, vs gauze). All dressings ranked better than gauze in infection rate except for hydrofiber (OR 1.46, 95% CI 0.02-112.53) and fabric dressings (OR 1.46, 95% CI 0.24-9.02). For blister reduction, alginate (SUCRA = 87.7%) and hydrofiber with hydrocolloid (SUCRA = 92.3%) were ranked as the optimal dressings before and after a sensitivity analysis, respectively. Antimicrobial dressing (SUCRA = 83.7%) demonstrated the most efficacy for preventing PJI. CONCLUSION Based on the evidence from our analysis, an antimicrobial dressing is the optimal dressing to prevent PJI. If negative-pressure wound therapy is used, surgeons should be aware of an increased incidence of blister formation. Further studies should focus on the alginate versus hydrofiber and hydrocolloid dressing to determine the optimal dressing to reduce blisters.
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Affiliation(s)
- Feng-Chih Kuo
- Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Timothy L Tan
- Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Po-Cheng Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Abstract
Pruritus pigmentosa is a skin disease mainly characterized by pruritus, inflammatory rash and reticular and macular pigmentation. The disease more commonly affects young women and may persist for several years. In this article, we report a case of a 20-year-old female patient who presented with erythema and blisters on the neck and trunk with pruritus for 20 days. Dermatological examination revealed a reticular distribution of erythema on the chest and abdomen and some areas of erythema covered with crusts. Additionally, blisters and bullae with clear fluid and negative Nikolsky's sign were noted. On the neck and back, erythema was also in a reticular distribution, and erythema secondary to erosion and/or crusts was present. In addition, histopathological analysis of the lesions showed hyperkeratosis and intraepidermal multilocular vesiculation and confirmed increased migration of inflammatory cells into the epidermis and infiltration of inflammatory cells, including lymphocytes, histiocytes and eosinophils, in the superficial dermis. The expression levels of IgG, IgM, IgA and C3 were all negative. This patient was diagnosed with prurigo pigmentosa, and the condition improved after treatment with minocycline.
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Affiliation(s)
- Jie Yang
- The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China
| | | | - Min Zhang
- The Fifth People's Hospital of Hainan Province, Haikou, Hainan, China
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Abstract
Dyshidrosiform bullous pemphigoid is a variant of bullous pemphigoid. At least 84 patients with dyshidrosiform bullous pemphigoid have been described. Dyshidrosiform bullous pemphigoid usually presents with pruritic blisters in elderly individuals; the hemorrhagic or purpuric lesions on the palms and soles can be the only manifestation of the disease. However, bullae may concurrently or subsequently appear on other areas of the patient's body. Patients typically improve after the diagnosis is established and treatment is initiated. The mainstay of therapy is systemic corticosteroids, with or without topical corticosteroids, and systemic dapsone or immunosuppressants. Drug-related or nickel-induced dyshidrosiform bullous pemphigoid improves after stopping the associated agent; however, systemic therapy has also been required to achieve resolution of the blisters. Similar to classic bullous pemphigoid, neurologic conditions and psychiatric disorders have been observed in dyshidrosiform bullous pemphigoid patients. The new onset of recurrent or persistent blisters on the palms, soles, or both of an elderly individual should prompt the clinician to consider the diagnosis of dyshidrosiform bullous pemphigoid.
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Sharma AK, Shukla SK, Kalonia A, Shaw P, Khanna K, Gupta R, Yashavarddhan MH, Bhatnagar A. Evaluation of decontamination efficacy of electrolytically generated hypochlorous acid for vesicating agent: A multimodel Study. Curr Pharm Biotechnol 2021; 23:287-299. [PMID: 33719970 DOI: 10.2174/1389201022666210311140922] [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] [Received: 07/23/2020] [Revised: 12/06/2020] [Accepted: 01/23/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sulfur Mustard is a strong vesicant and chemical warfare agent that imposes toxicity to the lungs, eyes, and skin after accidental or intended exposure. OBJECTIVES The current study was intended to explore in vitro and in vivo decontamination properties of electrolytically generated HOCl (hypochlorous acid) against CEES (2-chloroethyle ethyle sulphide), a known sulfur mustard simulant & vesicating agent. METHODS In vitro studies were carried out using UV spectroscopy and GC-MS methods. In vivo studies were perfomred in Strain A and immune compromised mice by subcutaneous as well as prophylactic topical administrion of HOCl pretreated CEES. The blister formation and mortality were considered as end-point. Histopathological study was conducted on skin samples by H & E method. DNA damage studies measuring γ-H2AX and ATM has been carried out in human blood using flow cytometry. Anti-bacterial action was tested by employing broth micro dilution methods. Comparative study was also carried out with known oxidizing agents. RESULTS The topical application of pre-treated CEES at 5, 30 min and 1 h time points showed significant (p<0.001) inhibition of blister formation. DNA damage study showed reduced mean flourences intensity of DSBs nearly 17-20 times, suggesting that HOCl plays a protective role against DNA damage. Histopathology showed no sign of necrosis in the epidermis upto 5 min although moderate changes were observed at 30 min. Pretreated samples were analyzed for detection of reaction products with m/z value of 75.04, 69.08, 83.93, 85.95, 123.99, 126.00, and 108.97. HOCl showed strong bactericidal effect at 40 ppm. The absorbance spectra of HOCl treated CEES showed lowered peaks in comparison to CEES alone and other oxidizing agents Conclusion: In a nutshell, our results signify the decontamination role of HOCl for biological surface application.
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Affiliation(s)
- Ajay Kumar Sharma
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi-110054. India
| | - Sandeep Kumar Shukla
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi-110054. India
| | - Aman Kalonia
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi-110054. India
| | - Priyanka Shaw
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi-110054. India
| | - Kushagra Khanna
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi-110054. India
| | - Richa Gupta
- Graphic Era Deemed to be University, Dehradun. India
| | - M H Yashavarddhan
- Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi-110054. India
| | - Assem Bhatnagar
- Institute of Nuclear Medicine & Allied Sciences, Defence Research and Development Organization, Lucknow Road, Timarpur, Delhi-110054. India
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Ma J, Cahill DG, Miljkovic N. Condensation Induced Blistering as a Measurement Technique for the Adhesion Energy of Nanoscale Polymer Films. Nano Lett 2020; 20:3918-3924. [PMID: 32320258 DOI: 10.1021/acs.nanolett.0c01086] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Polymeric coatings having micro-to-nanoscale thickness show immense promise for enhancing thermal transport, catalysis, energy conversion, and water collection. Characterizing the work of adhesion (G) between these coatings and their substrates is key to understanding transport physics as well as mechanical reliability. Here, we demonstrate that water vapor condensation blistering is capable of in situ measurement of work of adhesion at the interface of polymer thin films with micrometer spatial resolution. We use our method to characterize adhesion of interfaces with controlled chemistry such as fluorocarbon/fluorocarbon (CFn/CFm, n, m = 0-3), fluorocarbon/hydrocarbon (CFn/CHm), fluorocarbon/silica (CFn/SiO2), and hydrocarbon/silica (CHn/SiO2) interfaces showing excellent agreement with adhesion energy measured by the contact angle approach. We demonstrate the capability of our condensation blister test to achieve measurement spatial resolutions as low as 10 μm with uncertainties of ∼10%. The outcomes of this work establish a simple tool to study interfacial adhesion.
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Affiliation(s)
- Jingcheng Ma
- Department of Mechanical Science and Engineering, University of Illinois, Urbana, Illinois 61801, United States
| | - David G Cahill
- Department of Mechanical Science and Engineering, University of Illinois, Urbana, Illinois 61801, United States
- Materials Research Laboratory, University of Illinois, Urbana, Illinois 61801, United States
- Department of Material Science and Engineering, University of Illinois, Urbana, Illinois 61801, United States
| | - Nenad Miljkovic
- Department of Mechanical Science and Engineering, University of Illinois, Urbana, Illinois 61801, United States
- Materials Research Laboratory, University of Illinois, Urbana, Illinois 61801, United States
- Department of Electrical and Computer Engineering, University of Illinois, Urbana, Illinois 61801, United States
- International Institute for Carbon Neutral Energy Research (WPI-I2CNER), Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
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Abstract
Viral infections of the oral cavity usually manifest as either ulceration or blistering presentation of oral tissues. Oral viral infections are encountered in dental practice but received less clinical interest due to the lesser frequency of patients and diagnostic challenges. The clinical presentation, pathogenic mechanism, investigations, and management of oral viral infections are integrated into the article which will enable general dentists to develop critical thinking processes on differential diagnosis and management through a multidisciplinary approach with specialist dentists.
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Affiliation(s)
- Arvind Babu Rajendra Santosh
- Oral and Maxillofacial Pathologist, School of Dentistry, The University of the West Indies, Mona, Kingston, Jamaica, West Indies, Jamaica
| | - Keerthi Muddana
- Oral and Maxillofacial Pathologist, Department of Oral and Maxillofacial Pathology, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda - 508 254, Telangana, India
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Abstract
Bullous pemphigoid is an autoimmune blistering disorder that typically presents in elderly patients as pruritic tense subepidermal blisters on the lower trunk, axilla, and groin. It is caused by circulating and tissue-bound autoantibodies directed against bullous pemphigoid antigen 1 or bullous pemphigoid antigen 2 or both. Dyshidrosiform bullous pemphigoid is a rare variant of bullous pemphigoid, and it usually presents as itchy, potentially hemorrhagic, or purpuric blisters on the palms and/or soles of elderly individuals; subsequently, typical bullous lesions of bullous pemphigoid appear on other body sites. In our study, we report the features of two men with dyshidrosiform bullous pemphigoid and review the characteristics of individuals with this rare subtype of bullous pemphigoid. Including the men whose condition is described in this paper, at least 72 patients with dyshidrosiform bullous pemphigoid have been reported so far. However, complete features of the condition have not been described for all of the individuals. Based on the cases reported so far, the condition was slightly more common in women and the onset of the disease, for most of the patients, occurred between the ages of 61 and 94 years. The patients usually presented with blisters on both their palms and soles (66%) or just their soles (31%); 77% of the patients had progression of bullous pemphigoid to other areas of their body. Whether hemorrhagic blisters or purpuric lesions are associated with dyshidrosiform bullous pemphigoid remains to be determined; these features were present in 91% of the 22 patients who were described in the case reports yet were only observed in 5% of the individuals from a single larger series of 20 patients. The mainstay of therapy for dyshidrosiform bullous pemphigoid is systemic corticosteroids, with or without topical corticosteroids, and/or systemic dapsone or immunosuppressants; nearly all of the patients showed improvement after the treatment was initiated. Similar to individuals with bullous pemphigoid, at least nine of the dyshidrosiform bullous pemphigoid patients, including both patients in this report, had either a neurologic condition (seven patients) or both a neurologic condition and a psychiatric disorder (two patients). Usually, an autoimmune bullous disease, particularly dyshidrosiform bullous pemphigoid, is not initially considered in patients who present with blisters restricted to the palms and/or soles. Indeed, the lesion morphology of dyshidrosiform bullous pemphigoid mimics several other conditions that are characterized by blisters on the hands and feet, such as allergic and irritant contact dermatitis, chronic bullous disease of childhood, cutaneous T-cell lymphoma, dermatophyte infection, dyshidrosis or pompholyx, epidermolysis bullosa acquisita, erythema multiforme, herpes gestationis, lichen planus, linear IgA disease, scabies, and systemic contact dermatitis. In conclusion, the possibility of dyshidrosiform bullous pemphigoid should be considered in elderly individuals who present with the new onset of palmar and/or plantar blisters that are either recurrent or recalcitrant to therapy or would subsequently also appear on other areas of the body.
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Affiliation(s)
- Philip R Cohen
- Dermatology, San Diego Family Dermatology, San Diego, USA
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Salińska M, Kowalska H, Torzecka JD, Waszczykowska E, Woźniacka A. [Phototoxic reaction due to solar radiation exposure in a psoriatic patient treated with PUVA therapy]. Med Pr 2019; 70:763-768. [PMID: 31512683 DOI: 10.13075/mp.5893.00881] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
A phototoxic reaction may be induced by additional exposure to solar radiation during photochemotherapy (psoralen, ultra-violet A - PUVA treatment). A woman was admitted to Dermatology and Venereology Clinic in Łódź as an emergency case due to extensive erythematous-vesicular lesions on the skin of the lower limbs, accompanied by pain, itching and burning of the skin. The interview found that the patient was undergoing PUVA phototherapy for psoriatic lesions, with hypertension and nicotine dependence. Physical examination revealed large blisters, filled with serum and congestive erythematous lesions located on the lateral surfaces of the thighs and backs of the feet, as well as marked swelling of the lower limbs. Also, discs coated with thin scales were found on the upper and lower limbs and on the trunk. The entire body was intensely tanned. The patient was diagnosed with acute phototoxic reaction and general corticosteroids, antihistamine drugs, an antibiotic, antihypertensive drugs and topical treatment were introduced. Immunological tests were performed during the first days of hospitalization following the emergence of new blisters. Negative results ruled out bullous pemphigoid and pemphigus. Gradual clinical improvement was observed. To avoid the occurrence of acute phototoxicity during phototherapy, patients require education about the need to avoid UV exposure and to use photoprotection, when receiving UV-sensitizing treatment. Med Pr. 2019;70(6):763-8.
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Affiliation(s)
- Magdalena Salińska
- Uniwersytecki Szpital Kliniczny im. WAM - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy Central Veterans' Hospital, Łódź, Poland (Klinika Dermatologii i Wenerologii / Dermatology and Venereology Clinic)
| | - Hanna Kowalska
- Uniwersytecki Szpital Kliniczny im. WAM - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy Central Veterans' Hospital, Łódź, Poland (Klinika Dermatologii i Wenerologii / Dermatology and Venereology Clinic)
| | - Jolanta Dorota Torzecka
- Uniwersytecki Szpital Kliniczny im. WAM - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy Central Veterans' Hospital, Łódź, Poland (Klinika Dermatologii i Wenerologii / Dermatology and Venereology Clinic)
| | - Elżbieta Waszczykowska
- Uniwersytecki Szpital Kliniczny im. WAM - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy Central Veterans' Hospital, Łódź, Poland (Klinika Dermatologii i Wenerologii / Dermatology and Venereology Clinic)
| | - Anna Woźniacka
- Uniwersytecki Szpital Kliniczny im. WAM - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy Central Veterans' Hospital, Łódź, Poland (Klinika Dermatologii i Wenerologii / Dermatology and Venereology Clinic)
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Abstract
Introduction Bed bug infestations have risen dramatically in many industrialized nations in recent decades. Most people fed upon by bed bugs will develop a pruritic rash although the frequency with which this occurs is not definitively known and may depend on host factors including the duration of the infestation. Methods Surveys were completed from 706 emergency department (ED) patients in Cleveland, OH about their current and past exposure with bed bugs. Subjects were asked about any post-bed bug feeding rashes that developed. Results There were 24% (169/698) of subjects reporting either a current or past home bed bug infestation, with 37% (253/698) reporting they had previously been fed upon by a bed bug. Of those reporting a previous bed bug feeding, 68% (172/253) reported a pruritic post-bed bug feeding rash and 24% (57/237) reported developing a blister. Overall, 5% (37/705) of ED patients reported currently having a rash, but only 2% (14/698) of ED patients reported currently have bed bugs at home and of those, only 14% (2/14) said they currently had a rash. Conclusion While 68% of ED patients reported a pruritic post-bed bug feeding pruritic rash, almost a third of persons did not report developing the rash. Post-bed bug feeding blister reactions are less common. Asking ED patients about a rash had a low sensitivity of 14% (2-43%) and a specificity 95% (93-96%) to identify persons reporting home bed bugs.
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Affiliation(s)
| | | | | | - Brianna L Arko
- Clinical Research / Trauma Surgery, The MetroHealth System, Cleveland, USA
| | - Colin Dunn
- Emergency Medicine, University Hospitals, Cleveland, USA
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Messingham KN, Crowe TP, Fairley JA. The Intersection of IgE Autoantibodies and Eosinophilia in the Pathogenesis of Bullous Pemphigoid. Front Immunol 2019; 10:2331. [PMID: 31636640 PMCID: PMC6787172 DOI: 10.3389/fimmu.2019.02331] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [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: 07/12/2019] [Accepted: 09/16/2019] [Indexed: 12/13/2022] Open
Abstract
Bullous pemphigoid (BP) is an autoimmune blistering disease characterized by autoantibodies targeting cellular adhesion molecules. While IgE autoantibodies are occasionally reported in other autoimmune blistering diseases, BP is unique in that most BP patients develop an IgE autoantibody response. It is not known why BP patients develop self-reactive IgE and the precise role of IgE in BP pathogenesis is not fully understood. However, clinical evidence suggests an association between elevated IgE antibodies and eosinophilia in BP patients. Since eosinophils are multipotent effector cells, capable cytotoxicity and immune modulation, the putative interaction between IgE and eosinophils is a primary focus in current studies aimed at understanding the key components of disease pathogenesis. In this review, we provide an overview of BP pathogenesis, highlighting clinical and experimental evidence supporting central roles for IgE and eosinophils as independent mediators of disease and via their interaction. Additionally, therapeutics targeting IgE, the Th2 axis, or eosinophils are also discussed.
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Affiliation(s)
- Kelly N Messingham
- Department of Dermatology, The University of Iowa, Iowa City, IA, United States
| | - Tyler P Crowe
- Department of Dermatology, The University of Iowa, Iowa City, IA, United States
| | - Janet A Fairley
- Department of Dermatology, The University of Iowa, Iowa City, IA, United States.,Iowa City VA Medical Center, Iowa City, IA, United States
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39
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Hoffman MD. Participant Opinions and Expectations about Medical Services at Ultramarathons: Findings from the Ultrarunners Longitudinal TRAcking (ULTRA) Study. Cureus 2019; 11:e5800. [PMID: 31728247 PMCID: PMC6827872 DOI: 10.7759/cureus.5800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background This work explores the opinions and expectations of ultramarathon runners about medical services and their perceived quality during ultramarathons. Methods Focused questions related to medical services at ultramarathons were included in the 2018 survey of Ultrarunners Longitudinal TRAcking (ULTRA) Study enrollees. Results Among the 1,156 respondents, 83.2% agreed that ultramarathons should provide at least a minimum level of medical support with basic first aid and emergency transport services rated as the most important medical services, and individuals with basic first aid training rated as the most important medical providers at ultramarathons. Participant safety was felt to largely be the responsibility of each runner as well as the race and/or medical director. Among 832 respondents having completed an ultramarathon in 2016-2018, their impression of medical services at 4,853 ultramarathons was generally favorable. Of the four percent of times in which medical support was needed, it met expectations 74% of the time. Of the total of 240 different medical issues for which medical support was needed, blister management was the most common, accounting for 26.7% of issues. Conclusions Even though medical services receive minimal utilization during ultramarathons, ultramarathon runners largely believe that these events should provide at least a minimum level of medical support. Ultramarathon runners place a high onus for safety during ultramarathons on themselves, but they also place a high level of responsibility on race and medical directors, so it is prudent for the race and medical directors to consider this information and avoid a mismatch between runner expectations and the medical services actually provided.
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Affiliation(s)
- Martin D Hoffman
- Physical Medicine and Rehabilitation, University of California, Davis, USA
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40
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Li KY, Tang JP, Liang XT, Zhao ZY, Yue SZ. [Recurrent skin blisters for more than 7 months in a girl aged 15 months]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:919-923. [PMID: 31506154 PMCID: PMC7390251 DOI: 10.7499/j.issn.1008-8830.2019.09.015] [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] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/02/2019] [Indexed: 06/10/2023]
Abstract
A girl, aged 15 months, attended the hospital due to recurrent skin erythema, blisters, and desquamation for more than 7 months. Giemsa staining and immunohistochemical staining showed mast cell infiltration and degranulation. Hematoxylin staining showed spinous layer edema and blister formation under the epidermis, with a large amount of serous fluid and a small number of inflammatory cells in the blister. Marked edema was observed in the dermis, with diffused mononuclear cell infiltration. The girl was diagnosed with mastocytosis. Mastocytosis should be considered for children with recurrent skin erythema and blisters.
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Affiliation(s)
- Ke-Yao Li
- Department of Dermatology, Hunan Children's Hospital, Changsha 410007, China.
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Ibiapina HNS, Costa AG, Sachett JAG, Silva IM, Tarragô AM, Neves JCF, Kerr MWA, Santana MF, Martins-Filho OA, Lacerda MVG, Ferreira LCL, Malheiro A, Monteiro WM. An Immunological Stairway to Severe Tissue Complication Assembly in Bothrops atrox Snakebites. Front Immunol 2019; 10:1882. [PMID: 31474982 PMCID: PMC6705225 DOI: 10.3389/fimmu.2019.01882] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 03/07/2019] [Accepted: 07/24/2019] [Indexed: 01/05/2023] Open
Abstract
Snakebites are a serious public health problem and, in the Amazon, the Bothrops atrox snake is the most frequent cause of envenomation. B. atrox venom (BaV) causes pathophysiological changes with intense, local inflammatory processes, such as severe tissue complication (STC). However, mechanisms associated with the inflammatory process in humans are still poorly understood. Thus, in this study, we sought to describe the profile of local and systemic immunological soluble molecules in Bothrops envenomation patients treated at a specialist tertiary healthcare unit in the Brazilian Amazon. An analytical and prospective study was performed with patients who had snakebites with different clinical outcomes (STC and Mild Tissue Complication-MTC) using venous blood and blister exudate in order to measure immunological soluble molecules present in the response process. Twenty STC patients and 20 MTC patients were eligible for the study. In addition, 20 healthy donors (HD) who had never been bitten by a snake were used as controls. The biomarkers CXCL-8, CCL-5, CXCL-9, CCL-2 and CXCL-10; C3a, C4a, and C5a; IL-1, IL-2, IL-4, IL-5, IL-6, IL-10, TNF, IFN-γ and IL-17A were quantified using flow cytometry and ELISA. The circulating response profile differs between the studied groups, with MTC patients presenting a mixed profile and STC patients presenting a more polarized profile for Th1 response. In addition, individuals who develop STC have a more intense local immune response, because the tissue response differs from the circulating immunological soluble molecules and presents Th1/Th2/Th17 response polarization. Furthermore, these results suggest that CCL-2 and CXCL-10 are biomarkers for STC and the response profile they assume against Bothrops snakebite should reflect in the clinical practice for the patient.
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Affiliation(s)
- Hiochelson Najibe Santos Ibiapina
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Allyson Guimarães Costa
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil.,Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas (UFAM), Manaus, Brazil.,Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus, Brazil.,Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Universidade do Estado do Amazonas (UEA), Manaus, Brazil
| | - Jacqueline Almeida Gonçalves Sachett
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Iran Mendonça Silva
- Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Andréa Monteiro Tarragô
- Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas (UFAM), Manaus, Brazil.,Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus, Brazil
| | - Juliana Costa Ferreira Neves
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Marllon Wendell Athaydes Kerr
- Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus, Brazil.,Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Universidade do Estado do Amazonas (UEA), Manaus, Brazil
| | - Monique Freire Santana
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisas em Biomarcadores de Diagnóstico e Monitoração, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brazil
| | - Marcus Vinícius Guimarães Lacerda
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil.,Instituto de Pesquisas Leônidas & Maria Deane, FIOCRUZ-Amazônia, Manaus, Brazil
| | - Luiz Carlos Lima Ferreira
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Adriana Malheiro
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Programa de Pós-Graduação em Imunologia Básica e Aplicada, Instituto de Ciências Biológicas, Universidade Federal do Amazonas (UFAM), Manaus, Brazil.,Diretoria de Ensino e Pesquisa, Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM), Manaus, Brazil.,Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Universidade do Estado do Amazonas (UEA), Manaus, Brazil
| | - Wuelton Marcelo Monteiro
- Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Brazil.,Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
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42
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Tanoğlu O, Gökgöz MB, Özmeriç A, Alemdaroğlu KB. Two-Stage Surgery for the Malleolar Fracture-Dislocation With Severe Soft Tissue Injuries Does Not Affect the Functional Results. J Foot Ankle Surg 2019; 58:702-705. [PMID: 31079983 DOI: 10.1053/j.jfas.2018.11.033] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Indexed: 02/03/2023]
Abstract
Soft tissue injuries associated with malleolar fracture-dislocations may increase postoperative rates of wound complication. Ankle-spanning frame plays a fundamental role in the local damage control orthopedics while gaining time for definitive surgery. The objective of this study was to evaluate the effect of a 2-stage surgery for the unstable malleolar fracture-dislocations with severe soft tissue injuries compared to a 1-stage surgery in terms of the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle and Olerud-Molander ankle scores (OMAS). We analyzed 45 patients who met our study criteria. The patients were divided into 2 groups according to staged surgeries. Demographic data of patients, comorbidities, alcohol and tobacco use, Tscherne soft tissue injury scores, the AOFAS hindfoot-ankle and OMAS, postoperative complications, total hospitalization times, waiting time between stages, and waiting time from admission to surgery times were investigated. There was a statistically significant difference between the groups in terms of the mean total hospitalization times (p = .007), waiting time from admission to surgery (p < .001), gender (p = .005), and Tscherne soft tissue injury scores (p < .001). The mean AOFAS hindfoot-ankle and OMAS of the groups did not differ statistically at a minimum of 12 months of the follow-up period (p = .094 and p = .126, respectively). A 2-stage surgery can be performed safely in the carefully selected patients with the unstable malleolar fracture-dislocations with Tscherne grades 2 and 3 soft tissue injuries, and this surgery does not affect the postoperative AOFAS hindfoot-ankle and OMAS statistically compared to a 1-stage surgery at a minimum of 12 months of the follow-up period.
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Affiliation(s)
- Oğuzhan Tanoğlu
- Specialist in Orthopedics, Department of Orthopedics and Traumatology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey.
| | - Mehmet Burak Gökgöz
- Resident Doctor in Orthopedics, Department of Orthopedics and Traumatology, University of Health Sciences, Ankara Research and Training Hospital, Ankara, Turkey
| | - Ahmet Özmeriç
- Associate Professor in Orthopedics, Department of Orthopedics and Traumatology, University of Health Sciences, Ankara Research and Training Hospital, Ankara, Turkey
| | - Kadir Bahadır Alemdaroğlu
- Professor in Orthopedics, Department of Orthopedics and Traumatology, University of Health Sciences, Ankara Research and Training Hospital, Ankara, Turkey
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43
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Herz-Ruelas ME, Barboza-Quintana O, Cuéllar-Barboza A, Cárdenas-de la Garza JA, Gómez-Flores M. Acral bullous lichen sclerosus intolerant to UVA-1 successfully treated with narrowband ultraviolet B phototherapy. Photodermatol Photoimmunol Photomed 2019; 35:378-380. [PMID: 31062884 DOI: 10.1111/phpp.12478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/11/2019] [Accepted: 05/01/2019] [Indexed: 11/30/2022]
Abstract
Lichen sclerosus (LS) is an uncommon, chronic, lymphocyte-mediated, inflammatory dermatosis characterized by ivory-white patches with scar-like atrophy. Extragenital bullous lichen sclerosus may rarely affect palms and soles, causing severe pain and substantially impairing quality of life. We present the first case of acral bullous lichen sclerosus intolerant to UVA-1 phototherapy successfully treated with low doses of narrowband ultraviolet B phototherapy.
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Affiliation(s)
| | - Oralia Barboza-Quintana
- Pathology Department, Universidad Autónoma de Nuevo León, Monterrey, México.,Hospital Universitario "Dr. José E. González" y Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Adrián Cuéllar-Barboza
- Hospital Universitario "Dr. José E. González" y Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, México.,Dermatology Department, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Jesús Alberto Cárdenas-de la Garza
- Hospital Universitario "Dr. José E. González" y Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, México.,Dermatology Department, Universidad Autónoma de Nuevo León, Monterrey, México
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44
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Affiliation(s)
| | | | - Louise Newell
- Pediatric Dermatology Bristol Royal Hospital for Children Bristol, United Kingdom
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45
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Yoshii S, Uda K, Miyairi I, Nakao H, Kono N, Kubota M, Ishiguro A. Multiple Bullae Associated with Human Parvovirus B19. J Pediatr 2018; 202:327-327.e1. [PMID: 29937083 DOI: 10.1016/j.jpeds.2018.05.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 05/21/2018] [Indexed: 11/21/2022]
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46
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Ho JD, Al-Haseni A, Smith S, Bhawan J, Sahni D. Bullous complex regional pain syndrome: A description of the clinical and histopathologic features. J Cutan Pathol 2018; 45:633-635. [PMID: 29704267 DOI: 10.1111/cup.13266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/24/2018] [Accepted: 04/24/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Jonathan D Ho
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.,Section of Dermatopathology, Boston University School of Medicine, Boston, Massachusetts.,Departments of Dermatology and Pathology, University of the West Indies, Kingston, Jamaica
| | - Ali Al-Haseni
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Stephanie Smith
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Jag Bhawan
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.,Section of Dermatopathology, Boston University School of Medicine, Boston, Massachusetts
| | - Debjani Sahni
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
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47
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Shen Q, Ran G, Zhou W, Ye C, Feng Q, Li N. Investigation of Surface Morphology of 6H-SiC Irradiated with He⁺ and H₂⁺ Ions. Materials (Basel) 2018; 11:E282. [PMID: 29439460 DOI: 10.3390/ma11020282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/05/2018] [Accepted: 02/09/2018] [Indexed: 12/03/2022]
Abstract
Light ion implantation is one of the important procedures of smart cut for SiC-based semiconductor fabrication. This work investigated the surface morphologies and microstructures of single crystal 6H-SiC irradiated by one or both of H2+ and He+ ions at room temperature and then annealed at specific temperatures. Blisters evolved from the coalescence of H nanocracks were formed in the H2+ and He++H2+ irradiated sample surface, while circular ripples originated from the pressure release of helium bubbles after high temperature annealing were formed in the He+ irradiated sample surface. The lateral radius a of the blisters in the irradiated sample with low H2+ fluence was larger than that in the irradiated sample with high H2+ fluence and with He++H2+ ions. About 8–58% of implanted H atoms contributed to the formation of the blisters. Compared with other irradiated samples, the ratio of w0/a and the density of the blisters in the He++H2+ irradiated samples were largest. The stress field of the blisters was simulated using finite element method and the inner pressure in the blisters was also calculated. The corresponding mechanism was analyzed and discussed.
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48
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Abstract
Angina bullosa hemorrhagica (ABH) is a benign disorder of the oral cavity. Clinically, oral, blood-filled blisters are seen. To give a proper diagnosis, one should rule out any other cause. We aim to present this case in order to emphasize this rare cause of oral bullae which is necessary to be differentiated from many serious dermatological and hematological disorders.
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Affiliation(s)
- Salih Levent Cinar
- Dermatology and Venereology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Demet Kartal
- Dermatology and Venereology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Özlem Canöz
- Pathology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Murat Borlu
- Dermatology and Venereology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Ayten Ferahbas
- Dermatology and Venereology, Erciyes University Faculty of Medicine, Kayseri, Turkey
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49
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50
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Masunaga T, Ogawa J, Akiyama M, Nishikawa T, Shimizu H, Ishiko A. Compound heterozygosity for novel splice site mutations of ITGA6 in lethal junctional epidermolysis bullosa with pyloric atresia. J Dermatol 2016; 44:160-166. [PMID: 27607025 DOI: 10.1111/1346-8138.13575] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/22/2016] [Accepted: 07/29/2016] [Indexed: 11/29/2022]
Abstract
Junctional epidermolysis bullosa with pyloric atresia (PA-JEB) is a rare congenital bullous disease with gastrointestinal disturbance that has been associated with mutations in ITGA6 or ITGB4 encoding the α6 or β4 subunit of integrin, respectively. Only six ITGA6 mutations in PA-JEB have been reported while many ITGB4 mutations have been identified, and all the ITGA6 mutations were homozygous. Here, we report a case of lethal type PA-JEB, in which immunofluorescence showed the lack of both α6 and β4 integrins resulting from compound heterozygous splice site mutation in ITGA6, c.387G>T and c.2506-1G>C. Maternal c.387G>T induced the skipping of the entire exon 3 and both exons 3 and 4, resulting in premature termination codon and in-frame deletion, respectively. Paternal c.2506-1G>C caused the skipping of the exon 20 and resulted in in-frame deletion. As a reason why the present case showed lethal phenotype despite the in-frame deletion mutation, rapid degradation of neo-synthesized α6 protein and/or impaired transport of integrin were suggested from previous reports, and the lack of localization of integrin α6β4 to the epidermal basement membrane resulted in skin fragility. Our case expands the variety of integrin α6 mutations in PA-JEB.
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Affiliation(s)
- Takuji Masunaga
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.,Research Laboratory, KOSÉ Corporation, Tokyo, Japan
| | - Junki Ogawa
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.,Ogawa Skin Clinic, Kyoto, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeji Nishikawa
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.,Samoncho Dermatological Clinic, Tokyo, Japan
| | - Hiroshi Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akira Ishiko
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.,Department of Dermatology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
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