RESUMEN
13-cis-retinoic acid (13-cRA) is a safe treatment for severe acne, as it has immunomodulatory effects such as enhancing the antigen-presenting activity of epidermal Langerhans cells (LCs) and T-cell activity. The aim of this study was to prospectively show the alteration of sensitization and irritation reactions in acne patients undergoing 13-cRA therapy. This cross-sectional descriptive study consisted of 65 severe to refractory acne patients. The standard thin-layer rapid-use epicutaneous test (T.R.U.E. test) was used to screen sensitization and irritation reactions before and after 3-month 13-cRA treatment. Patch test results after 13-cRA therapy revealed an increase in newly formed sensitization and irritation reactions. Sensitization rate was significantly higher (43.1%) in the second patch test, when compared with the first patch test results (27.7%; P = 0.002). No statistical difference was found in irritation rates. In this study, the sensitization rate was higher after treatment, which could be attributed to the greater antigen penetration due to the disrupted barrier and/or the upregulation of antigen-presenting activity in LC. This would cause a more prominent immune reaction to antigens. Based on these findings, we suggest that 13-cRA may have a sensitization effect, and physicians should be aware of this complication due to 13-cRA treatment. (SKINmed. 2021;19:-0).
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/efectos adversos , Hipersensibilidad/epidemiología , Isotretinoína/efectos adversos , Adolescente , Presentación de Antígeno/inmunología , Antígenos/inmunología , Estudios Transversales , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/inmunología , Femenino , Humanos , Hipersensibilidad/inmunología , Isotretinoína/administración & dosificación , Isotretinoína/inmunología , Células de Langerhans/inmunología , Masculino , Pruebas del Parche , Estudios Prospectivos , Adulto JovenRESUMEN
There are many reports about contact dermatitis to nickel and side effects of isotretinoin, but the development of contact dermatitis to a previously tolerated allergen while taking isotretinoin is not well described. We report the case of a 19-year-old man who developed a new nickel allergy during isotretinoin treatment. We theorize that thinning of the stratum corneum by this medication allows for greater antigen presentation and thus sensitization to contact allergens.
Asunto(s)
Dermatitis Alérgica por Contacto/etiología , Fármacos Dermatológicos/efectos adversos , Isotretinoína/efectos adversos , Níquel/inmunología , Acné Vulgar/tratamiento farmacológico , Dermatitis Alérgica por Contacto/inmunología , Humanos , Isotretinoína/inmunología , Masculino , Adulto JovenAsunto(s)
Acné Vulgar/tratamiento farmacológico , Acné Vulgar/inmunología , Fármacos Dermatológicos/inmunología , Fármacos Dermatológicos/farmacología , Isotretinoína/inmunología , Isotretinoína/farmacología , Acné Vulgar/etiología , Citocinas/efectos de los fármacos , Citocinas/inmunología , Fármacos Dermatológicos/uso terapéutico , Humanos , Mediadores de Inflamación/inmunología , Isotretinoína/uso terapéutico , Linfocitos/efectos de los fármacos , Linfocitos/inmunología , Macrófagos/efectos de los fármacos , Macrófagos/inmunología , Monocitos/efectos de los fármacos , Monocitos/inmunología , Resultado del TratamientoRESUMEN
La isotretinoína es una droga efectiva para el tratamiento del acné. Su uso puede acompañarse de diversas reacciones adversas, tales como queilitis, xerodermia, epistaxis, prurito, trastornos oculares y cefalea. Presentamos un paciente de 17 años que desarrolló acné fulminans, eritema nodoso y complejos inmunes circulantes, diez días después de haber comenzado el tratamiento con isotretinoína. Se discuten los aspectos etiopatogénicos del acné fulminans
Asunto(s)
Masculino , Humanos , Adolescente , Acné Vulgar/complicaciones , Eritema Nudoso/inducido químicamente , Isotretinoína/efectos adversos , Acné Vulgar/diagnóstico , Acné Vulgar/tratamiento farmacológico , Hipersensibilidad a las Drogas/terapia , Eritema Nudoso/etiología , Isotretinoína/farmacología , Isotretinoína/inmunologíaRESUMEN
La isotretinoína es una droga efectiva para el tratamiento del acné. Su uso puede acompañarse de diversas reacciones adversas, tales como queilitis, xerodermia, epistaxis, prurito, trastornos oculares y cefalea. Presentamos un paciente de 17 años que desarrolló acné fulminans, eritema nodoso y complejos inmunes circulantes, diez días después de haber comenzado el tratamiento con isotretinoína. Se discuten los aspectos etiopatogénicos del acné fulminans (AU)
Asunto(s)
Masculino , Humanos , Adolescente , Isotretinoína/efectos adversos , Acné Vulgar/complicaciones , Eritema Nudoso/inducido químicamente , Acné Vulgar/diagnóstico , Acné Vulgar/tratamiento farmacológico , Eritema Nudoso/etiología , Isotretinoína/farmacología , Isotretinoína/inmunología , Hipersensibilidad a las Drogas/terapiaRESUMEN
Retinoic acid (RA) has been demonstrated to drive both phenotypic and functional in vitro differentiation of B cell hybridomas from patients with common variable immunodeficiency (CVI) who manifest an "intrinsic" defect in terminal B cell differentiation (J Exp Med 1988;168: 55-71). Therefore, we conducted an open trial to determine the effects of oral 13-cis RA (0.5 mg/kg/day; 12 weeks receiving and 12 weeks without drug) on in vivo B cell differentiation in subjects with CVI. At various times before, during, and after drug administration, patients' B cells were tested for changes in cell-surface phenotype and in vitro immunoglobulin production in response to recombinant cytokines. Before 13-cis RA, all patients had decreased Leu-8 coexpression on CD20+ cells. Seven of eight subjects demonstrated "normalization" of this phenotype after 8 to 16 weeks of 13-cis RA administration. Patients whose B cells demonstrated more than normal CD20 display also had a fall toward normal in this parameter. These effects persisted for 6 to 12 weeks after drug was stopped. It appears that 13-cis RA drives B cells of patients with CVI to express a more differentiated cell-surface phenotype and may promote functional differentiation in some patients.