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1.
Medicine (Baltimore) ; 103(12): e37553, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38518008

RESUMO

Pathergy test indicates nonspecific hyper-reactivity of the skin to aseptic trauma in Behçet syndrome (BS) and is considered as an adjunctive diagnostic test with a good specificity albeit with low sensitivity. We tested the hypothesis that a relationship exists between active clinical manifestations of BS and the pathergy-positivity when performed simultaneously. Pathergy test and detailed dermatologic examination were done in 105 BS patients (60M/45F); who were seen consecutively at the multi-disciplinary BS outpatient clinic in a single tertiary center. Information regarding demographic and clinical characteristics, pathergy test results at diagnosis, and details about treatment were obtained from patient charts. Disease activity was assessed using Behçet Disease Current Activity Form. Among 105 patients, 27 (25.7%) were pathergy-positive at the time of the study visit whereas 40.9% were pathergy-positive at the time of the diagnosis. There was no relation between pathergy test and patient age or disease duration, either. Pathergy-positivity was significantly more common in patients with folliculitis compared to those without folliculitis (40.7% vs 19.2%; P = .026). The test was also positive in all 3 patients with leg ulcers due to venous stasis. We found that among all skin-mucosa lesions only the presence of folliculitis was associated with pathergy positivity with statistical significance. It was also remarkable that the current pathergy was positive in all 3 patients with active leg ulcers but this finding warrants further studies because of the low patient numbers.


Assuntos
Síndrome de Behçet , Foliculite , Úlcera da Perna , Humanos , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/patologia , Pele/patologia , Testes Cutâneos , Foliculite/etiologia , Foliculite/complicações
2.
Acta Derm Venereol ; 104: adv12373, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38372472

RESUMO

Folliculitis decalvans and lichen planopilaris phenotypic spectrum has been described as a form of cicatricial alopecia. The aim of this study is to describe the clinical and trichoscopic features and therapeutic management of this condition in a series of patients. A retrospective observational unicentre study was designed including patients with folliculitis decalvans and lichen planopilaris phenotypic spectrum confirmed with biopsy. A total of 31 patients (20 females) were included. The most common presentation was an isolated plaque of alopecia (61.3%) in the vertex. Trichoscopy revealed hair tufting with perifollicular white scaling in all cases. The duration of the condition was the only factor associated with large plaques (grade III) of alopecia (p = 0.026). The mean time to transition from the classic presentation of folliculitis decalvans to folliculitis decalvans and lichen planopilaris phenotypic spectrum was 5.2 years. The most frequently used treatments were topical steroids (80.6%), intralesional steroids (64.5%) and topical antibiotics (32.3%). Nine clinical relapses were detected after a mean time of 18 months (range 12-23 months). Folliculitis decalvans and lichen planopilaris phenotypic spectrum is an infrequent, but probably underdiagnosed, cicatricial alopecia. Treatment with anti-inflammatory drugs used for lichen planopilaris may be an adequate approach.


Assuntos
Foliculite , Líquen Plano , Feminino , Humanos , Alopecia/diagnóstico , Alopecia/tratamento farmacológico , Alopecia/patologia , Cicatriz , Foliculite/diagnóstico , Foliculite/tratamento farmacológico , Líquen Plano/complicações , Líquen Plano/diagnóstico , Líquen Plano/tratamento farmacológico , Estudos Retrospectivos , Esteroides
3.
Mycoses ; 67(1): e13680, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38214420

RESUMO

CIITA, a member of NOD-like receptor (NLR) family, is the major MHC II trans-activator and mediator of Th1 immunity, but its function and interaction with NLRP3 have been little studied. We found activation of NLRP3 inflammasome, increased expression of CIITA, CBP, pSTAT1, STAT1, MHC II, IFN-γ and IFN-γ-inducible chemokines (CCL1 and CXCL8), and colocalisation of NLRP3 with CIITA in Malassezia folliculitis lesions, Malassezia globosa-infected HaCaT cells and mouse skin. CoIP with anti-CIITA or anti-NLRP3 antibody pulled down NLRP3 or both CIITA and ASC. NLRP3 silencing or knockout caused CIITA downexpression and their colocalisation disappearance in HaCaT cells and mouse skin of Nlrp3-/- mice, while CIITA knockdown had no effect on NLRP3, ASC, IL-1ß and IL-18 expression. NLRP3 inflammasome inhibitors and knockdown significantly suppressed IFN-γ, CCL1, CXCL8 and CXCL10 levels in M. globosa-infected HaCaT cells. CCL1 and CXCL8 expression was elevated in Malassezia folliculitis lesions and reduced in Nlrp3-/- mice. These results demonstrate that M. globosa can activate NLRP3 inflammasome, CIITA/MHC II signalling and IFN-γ-inducible chemokines in human keratinocytes and mouse skin. NLRP3 may regulate CIITA by their binding and trigger Th1 immunity by secreting CCL1 and CXCL8/IL-8, contributing to the pathogenesis of Malassezia-associated skin diseases.


Assuntos
Quimiocinas C , Foliculite , Malassezia , Humanos , Camundongos , Animais , Interferon gama , Interferons , Antígenos de Histocompatibilidade Classe II/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Inflamassomos , Regiões Promotoras Genéticas , Transativadores/genética , Transativadores/metabolismo , Quimiocinas/genética , Queratinócitos
5.
JAMA Dermatol ; 160(1): 114-115, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37910114

RESUMO

This case report describes a woman in her 20s who presented with an itchy erythematous-papulo-pustular eruption of the scalp for 3 months with progressive centrifugal extension to the face and was diagnosed with Ofuji disease.


Assuntos
Anticorpos Monoclonais Humanizados , Eosinofilia , Foliculite , Dermatopatias Vesiculobolhosas , Humanos , Eosinofilia/diagnóstico , Eosinofilia/tratamento farmacológico , Foliculite/diagnóstico , Foliculite/tratamento farmacológico , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/tratamento farmacológico
6.
JAMA Dermatol ; 160(1): 111-113, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38055241

RESUMO

This survey study describes an opportunity for a partnership between barbers and dermatologists to identify, evaluate, and treat pseudofolliculitis barbae in the Black male population.


Assuntos
Foliculite , Doenças do Cabelo , Remoção de Cabelo , Humanos , Foliculite/diagnóstico , Foliculite/terapia
7.
J Cutan Pathol ; 51(3): 205-208, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38063075

RESUMO

Herpes zoster (HZ) may have atypical clinical presentations, particularly in immunosuppressed patients. Nodular HZ is an extremely rare condition. We report the first case of recurrent papulonodular HZ in an adult patient with inflammatory bowel disease (IBD) receiving biologic treatment. More interestingly, there was no epidermal involvement on histopathological examination, but the involvement of the adnexa and blood vessels was a clue to the diagnosis in view of the clinical context. We wish to raise awareness of this rare manifestation of HZ for early diagnosis and proper treatment.


Assuntos
Foliculite , Herpes Zoster , Vasculite , Adulto , Humanos , Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Herpes Zoster/patologia , Herpesvirus Humano 3 , Foliculite/diagnóstico , Foliculite/patologia
9.
J Dermatol ; 51(1): 125-129, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37789597

RESUMO

Infancy associated eosinophilic pustular folliculitis (I-EPF) is a clinical variant of EPF that develops in childhood. Previous studies have suggested that I-EPF exhibits clinical and histological differences distinct from other variants, including classic EPF. Herein, we report two patients with I-EPF treated with topical indomethacin. These two cases exhibited less perifollicular and more perivascular eosinophilic infiltration, which is different in distribution from that of classic EPF. Immunohistochemical study demonstrated that the infiltrating mononuclear cells were CD4-dominant T cells in classic EPF and I-EPF, whereas the number of CD68-positive cells was significantly higher in classic EPF than in I-EPF. Immunohistochemical staining was also performed for eosinophilic pustular folliculitis (HPGDS), which has been reported to induce eosinophils and is a therapeutic target of indomethacin in classic EPF. HPGDS-positive cells were also observed in I-EPF, which may explain the effectiveness of topical indomethacin. Although clinical and histopathological features of I-EPF are different from other variants, the arachidonic acid pathway could be involved in eosinophil infiltration, not only in classic EPF but also in I-EPF.


Assuntos
Eosinofilia , Foliculite , Dermatopatias Vesiculobolhosas , Humanos , Indometacina/uso terapêutico , Eosinofilia/tratamento farmacológico , Eosinofilia/patologia , Foliculite/tratamento farmacológico , Foliculite/patologia , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Dermatopatias Vesiculobolhosas/patologia
13.
Skin Pharmacol Physiol ; 36(5): 259-266, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38104550

RESUMO

INTRODUCTION: Folliculitis is a painful infection and inflammation of the hair follicles, mostly caused by bacterial, fungal, or, more rarely, viral infections. Turpentine derivatives have been used traditionally to treat various skin infections and could thus also be effective in treating folliculitis. We carried out an open, prospective, randomized, placebo- and comparator-controlled multicenter trial to evaluate the efficacy and safety of an ointment containing pine turpentine oil, larch turpentine, and eucalyptus oil in the treatment of acute folliculitis. METHODS: Seventy outpatients with acute folliculitis were treated with the turpentine ointment, a comparator (povidone iodine solution), or a placebo (Vaseline) for 7 days. Photographs of the affected skin areas were taken by the physicians at four visits and by the patients on a daily basis. Photographs were evaluated by blinded observers. Primary efficacy endpoint was the change in total hair follicle lesion counts. Secondary endpoints included the evolution of the lesion counts in the course of the study, responder rate (improvement of follicle lesions by at least one count), and the patient's global assessment. Safety endpoints were the tolerability of the treatments and adverse event recording. RESULTS: A decrease of follicle lesions counts was detected for both active treatments but not for placebo, but the differences among groups were not statistically significant. As for the secondary endpoints, the ointment showed statistically significant superiority over placebo for the evolution of the lesions during the course of the study (p = 0.017), the responder rate (p = 0.032), and the subjective efficacy assessment by patients (p = 0.029). All treatments were equally well tolerated, with a similar number of treatment-emergent adverse events. CONCLUSION: The turpentine ointment is an effective and safe option for the treatment of folliculitis.


Assuntos
Foliculite , Terebintina , Humanos , Pomadas , Estudos Prospectivos , Foliculite/tratamento farmacológico , Pele , Resultado do Tratamento , Método Duplo-Cego
14.
Eur Rev Med Pharmacol Sci ; 27(21): 10705-10715, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37975396

RESUMO

BACKGROUND: Perforating dermatoses are heterogeneous skin disorders characterized by transepidermal elimination of dermal tissue components. Acquired perforating dermatoses can be divided into four types, according to the eliminated dermal materials: Kyrle disease, perforating reactive collagenosis, elastosis perforans serpiginosa, and perforating folliculitis. They characterize adult patients with coexisting systemic diseases, regardless of the dermal materials eliminated. The association between Kyrle disease and renal failure or diabetes mellitus is common. CASE REPORT: We reported the case of Kyrle disease in a patient with chronic kidney disease. A literature review was performed with the aim to highlight the associated comorbidities and point out the role of early and specific treatment of the cutaneous symptoms and manifestations. CONCLUSIONS: Being Kyrle disease a pruritic condition which adversely affects the patient's quality of life, it would be desirable to place greater therapeutic attention on the alleviation of itching and on the correct management of the underlying comorbidity.


Assuntos
Doenças do Colágeno , Doença de Darier , Foliculite , Dermatopatias , Adulto , Humanos , Qualidade de Vida , Doença de Darier/diagnóstico , Doença de Darier/complicações , Foliculite/complicações , Doenças do Colágeno/complicações , Doenças do Colágeno/diagnóstico , Prurido/complicações
15.
Med Mycol J ; 64(4): 85-94, 2023.
Artigo em Japonês | MEDLINE | ID: mdl-38030276

RESUMO

This is a report of the results of the epidemiological survey on dermatomycoses conducted in 2021. A total of 9,442 patients with dermatomycosis were reported for one year. They include 8,151 (86.3%) with dermatophytosis, 796 (8.4%) with candidiasis, 484 (5.1%) with Malassezia infection, and 11 (0.1%) with deep cutaneous mycosis. In order, the most common types of dermatophytoses were tinea pedis (4,195 cases, 2,341 males and 1,854 females), tinea unguium (2,711 cases, 1,509 males and 1,202 females), tinea corporis (674 cases, 445 males and 229 females), tinea cruris (399 cases, 305 males and 94 females), tinea manus (125 cases, 78 males and 47 females), and tinea capitis (47 cases, 25 males and 22 females). The number of cases of tinea pedis and tinea unguium increased during the summer. A higher percentage of patients were aged 80 or older than in previous surveys. These findings may reflect the increasing percentage of elderly patients seen and the superannuation of the population. As in previous surveys, Trichophyton rubrum and Trichophyton interdigitale were the two most frequently isolated species of fungi causing dermatophytoses. Microsporum canis and Trichophyton tonsurans were the two species most often causing tinea capitis.Regarding cutaneous candidiasis, while candidal intertrigo was the most common in previous surveys, diaper candidiasis in the elderly was the most common in this survey. A background check revealed that this was because a facility included a semi-prophylactic approach to address diaper candidiasis occurring within the ward.Malassezia infections by Malassezia folliculitis clearly increased with each survey. The tendency of certain facilities with many reports of Malassezia folliculitis suggests that it is greatly affected by the presence of physicians familiar with the disease.


Assuntos
Candidíase Cutânea , Candidíase , Dermatomicoses , Foliculite , Onicomicose , Tinha do Couro Cabeludo , Tinha , Masculino , Idoso , Feminino , Humanos , Tinha dos Pés/epidemiologia , Dermatomicoses/epidemiologia , Dermatomicoses/microbiologia , Onicomicose/epidemiologia , Japão/epidemiologia , Tinha/epidemiologia , Tinha/microbiologia , Candidíase/epidemiologia , Trichophyton
16.
J Dtsch Dermatol Ges ; 21(12): 1469-1477, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37875786

RESUMO

BACKGROUND: Folliculitis decalvans (FD) is a type of primary neutrophilic cicatricial alopecia often leading to irreversible hair loss. Data on its epidemiology, clinical features, outcomes, and prognostic factors are limited. OBJECTIVE: To evaluate a cohort of patients with FD and identify characteristics of severe disease and prognostic factors which impede remission. PATIENTS AND METHODS: This retrospective cohort study included 192 patients diagnosed with FD and followed for at least six months at a tertiary center between 2010 and 2020. RESULTS: There was a diagnostic delay averaging 22.2 (± 29.7) months. Comorbid follicular occlusion disorders were common. Bacterial cultures were positive in 45.6% of the cases, with Staphylococcus (S.) aureus being the most common pathogen. Severe disease was associated with comorbid hidradenitis suppurativa and a positive bacterial culture, particularly S. aureus. 50.7% of patients experienced complete remission: 32% within the first six months of treatment and 18.7% later during follow-up. Relapses were frequent. Negative prognostic factors for achieving remission included younger age and a positive bacterial culture. CONCLUSIONS: There is a need for the education of dermatologists to reduce the diagnostic delay. Screening FD patients for comorbid hidradenitis suppurativa and obtaining bacterial cultures is important for treatment planning.


Assuntos
Foliculite , Hidradenite Supurativa , Humanos , Estudos de Coortes , Diagnóstico Tardio , Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/epidemiologia , Hidradenite Supurativa/complicações , Prognóstico , Estudos Retrospectivos , Foliculite/diagnóstico , Foliculite/epidemiologia , Foliculite/tratamento farmacológico , Staphylococcus aureus , Alopecia/diagnóstico , Alopecia/epidemiologia , Alopecia/tratamento farmacológico
18.
Skinmed ; 21(3): 192-196, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37634105

RESUMO

SOTYKTUTM (deucravacitinib) is a newly approved oral agent for managing moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. Deucravacitinib is a highly selective allosteric tyrosine kinase 2 inhibitor targeting dysregulated cytokine responses in psoriasis patients. Its efficacy was demonstrated in two randomized, placebo- and active comparator-controlled phase 3 trials, where a significantly higher proportion of patients, up to 58.4% (194/332), achieved lessening of symptoms at week 16. The recommended dosing regimen of deucravacitinib is 6 mg once daily. More frequent adverse reactions occurring in the deucravacitinib-treated patients include upper respiratory infection (19.2% [161/840]), increase in blood creatine phosphokinase (2.7% [23/840]), herpes simplex infection (2.0% [17/840]), mouth ulcers (1.9% [16/840]), folliculitis (1.7% [14/840]), and acne (1.4% [12/840]). Continuance of treatment for up to week 52 did not increase the exposure-adjusted rates of adverse reactions. The selectivity and specificity of deucravacitinib treatment may improve its long-term safety profile, compared to other Janus kinase inhibitors.


Assuntos
Acne Vulgar , Foliculite , Psoríase , Humanos , Adulto , Psoríase/tratamento farmacológico , Comprimidos
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