RESUMO
BACKGROUND: Dental treatment for patients with self-reported metal allergy or concern about the possibility of having such an allergy is often difficult; such patients often undergo dermatological consultations for metal patch test (PT). OBJECTIVE: This study compared PT results for metal allergens and the clinical relevance of this among patients visiting Fukuoka Dental College Hospital. METHODS: We performed PT with metal allergens on patients with oral mucosa- or skin-related symptoms, or those concerned about adverse events associated with upcoming dental treatment. RESULTS: Fifty-nine patients were patch-tested with metal allergens. Thirty-four cases (58.8%) had self-reported metal allergy. Regarding comorbidities, atopic dermatitis was the most common (7 cases), followed by hand eczema, palmoplantar pustulosis, lichen planus, and abnormal sensation in the mouth. Overall, 25 of 59 cases had at least one positive PT reaction. The most common positive allergen was nickel sulfate (17 cases), followed by cobalt chloride, zinc chloride, and palladium chloride. The rate of positivity of metal PT was significantly higher in the self-reported metal allergy cases than in the others (P < 0.001). Other comorbidities were not significantly associated with those with or without self-reported metal allergy. Five of those without self-reported metal allergy showed positive PT reaction. CONCLUSIONS: Patients with self-reported metal allergy exhibited more metal PT reactions than those without this. One fifth of those without this showed positive metal PT reaction, implying the importance of PT for both with and without self-reported metal allergy. PT results are helpful for selecting dental metals for future prosthetic and orthodontic treatments.
Assuntos
Alérgenos/imunologia , Hipersensibilidade/imunologia , Metais/imunologia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Hipersensibilidade/epidemiologia , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Autorrelato , Testes Cutâneos , Adulto JovemRESUMO
The Guidelines for the Treatment of Acne Vulgaris of the Japanese Dermatological Association was first published in Japanese in 2008 and revised in 2016 and 2017. These guidelines (GL) indicate the standard acne treatments in Japan and address pharmaceutical drugs and treatments applicable or in use in Japan. In these GL, the strength of the recommendation is based on clinical evidences as well as availability in Japanese medical institutions. In the 2016 and 2017 GL, some of the clinical questions were revised, and other questions were added in accordance with approval of topical medicines containing benzoyl peroxide (BPO). Rather than monotherapies of antibiotics, the 2017 GL more strongly recommend combination therapies, especially fixed-dose combination gels including BPO in the aspects of pharmacological actions and compliance in the acute inflammatory phase to achieve earlier and better improvements. The 2017 GL also indicate to limit the antimicrobial treatments for the acute inflammatory phase up to approximately 3 months and recommend BPO, adapalene, and a fixed-dose combination gel of 0.1% adapalene and 2.5% BPO for the maintenance phase to avoid the emergence of antimicrobial-resistant Propionibacterium acnes. The 2017 GL also discuss rosacea, which requires discrimination from acne and a different treatment plan.
Assuntos
Acne Vulgar/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Dermatologia/normas , Sociedades Médicas/normas , Acne Vulgar/microbiologia , Adapaleno/uso terapêutico , Administração Cutânea , Antibacterianos/normas , Antibacterianos/uso terapêutico , Peróxido de Benzoíla/normas , Peróxido de Benzoíla/uso terapêutico , Fármacos Dermatológicos/normas , Combinação de Medicamentos , Farmacorresistência Bacteriana , Humanos , Japão , Naftalenos/normas , Naftalenos/uso terapêutico , Propionibacterium acnes/fisiologia , Resultado do TratamentoAssuntos
Dermatite Atópica/complicações , Doenças do Cabelo/complicações , Cabelo/anormalidades , Hipotricose/complicações , Lipase/genética , Pré-Escolar , Comorbidade , Análise Mutacional de DNA , Dermatite Atópica/genética , Feminino , Proteínas Filagrinas , Doenças do Cabelo/genética , Heterozigoto , Humanos , Hipotricose/genética , Proteínas de Filamentos Intermediários/genética , Mutação de Sentido Incorreto , LinhagemRESUMO
OBJECTIVES: To confirm that sera from some BP patients reactive exclusively to the BP230 and to study the clinical and immunological characteristics of this condition. MATERIALS AND METHODS: BP patients were divided into three groups: BP reactive only to BP230 (BP230-BP), BP reactive to both BP180 and BP230 (BP180-BP230-BP) and BP reactive only to BP180 (BP180-BP), based on the results of standard ELISAs for BP180 and BP230. Clinical features were statistically analyzed among the three groups. Then, targeted epitopes in each group were studied by immunoblotting and novel ELISAs using three domain-specific BP230 recombinant proteins. RESULTS: Forty-one, 65 and 47 of 153 BP patients were categorized as BP230-BP, BP180-BP230-BP and BP180-BP, respectively. Clinically, BP230-BP patients showed significantly lower severity, less need of systemic steroids and better responses to various treatments, suggesting that BP230-BP is a milder condition. Immunoblotting and ELISAs of domain-specific BP230 recombinant proteins indicated that, while BP180-BP230-BP sera reacted with all three domains of BP230, BP230-BP sera reacted more frequently with epitopes in the BP230 C-terminal domain. CONCLUSION: We propose a new disease entity, named anti-BP230-type BP, in which anti-BP230 antibodies might be pathogenic and react specifically with the BP230 C-terminal domain. While anti-BP230 antibodies in BP180-BP230-BP seem to be produced via intermolecular epitope spreading, anti-BP230 antibodies in BP230-BP are considered to be produced by different mechanisms.
Assuntos
Autoanticorpos/sangue , Autoantígenos/imunologia , Distonina/imunologia , Epitopos/imunologia , Colágenos não Fibrilares/imunologia , Penfigoide Bolhoso/imunologia , Idoso , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Masculino , Penfigoide Bolhoso/sangue , Penfigoide Bolhoso/tratamento farmacológico , Proteínas Recombinantes/imunologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Colágeno Tipo XVIIRESUMO
Although the major autoantigens in classic pemphigus are desmogleins, sera from various types of pemphigus react with a number of other molecules, including desmocollins and plakin proteins. However, other novel pemphigus-related autoantigens remain to be identified. In this study, immunoblotting for serum from an atypical autoimmune bullous disease patient identified an unknown 175 kDa protein. Subsequent studies using two-dimensional gel electrophoresis, immunoblotting and mass-spectrometry identified the 175 kDa protein as early endosome antigen 1 (EEA1). This finding was confirmed by subsequent immunological studies, including indirect immunofluorescence of skin and cultured keratinocytes, two-dimensional gel electrophoresis and immunoblotting with anti-EEA1 polyclonal antibody, and preabsorption with EEA1 recombinant protein. Finally, we developed a novel BIOCHIP assay using full-length EEA1 recombinant protein to detect anti-EEA1 antibodies. However, none of 35 sera from various types of pemphigus showed anti-EEA1 antibodies in the BIOCHIP assay, with the exception of the serum from the index case. In addition, various findings in the index case did not suggest pathogenic role of anti-EEA1 autoantibodies. Therefore, although we successfully identified the 175 kDa protein reacted by a serum of an atypical pemphigus-like patient as EEA1, novel BIOCHIP study for other pemphigus sera indicated that EEA1 is not a common and pathogenic autoantigen in pemphigus.
Assuntos
Autoanticorpos/imunologia , Pênfigo/imunologia , Proteínas de Transporte Vesicular/imunologia , Animais , Células COS , Chlorocebus aethiops , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Immunoreactants are found in the epidermal basement membrane in both lupus erythematosus and bullous pemphigoid (BP). To our knowledge, there are no comparative studies on direct immunofluorescence (DIF) of discoid lupus erythematosus (DLE) and BP. The authors studied DIF of lesional skins in 9 patients (2 males and 7 females) with DLE and 29 patients (11 males and 18 females) with BP to disclose the difference between these 2 diseases. IgG deposition was significantly more frequent at the epidermal basement membrane zone (BMZ) in the BP group than in the DLE group; however, IgA and IgM depositions were significantly more frequent at both the epidermal and follicular BMZs in the DLE group than in the BP group. In addition, the mean number of positive immunoreactants at both the epidermal and follicular BMZs was significantly larger in the DLE group than in the BP group. On an average, ≥3 immunoreactants were seen at the epidermal and follicular BMZs in DLE, whereas ≤2.5 immunoreactants were seen in BP. DIF may contribute to the differentiation between these 2 diseases.
Assuntos
Complemento C3/análise , Técnica Direta de Fluorescência para Anticorpo , Imunoglobulina A/análise , Imunoglobulina M/análise , Lúpus Eritematoso Discoide/imunologia , Penfigoide Bolhoso/imunologia , Pele/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos/análise , Biomarcadores/análise , Diagnóstico Diferencial , Feminino , Humanos , Lúpus Eritematoso Discoide/patologia , Masculino , Pessoa de Meia-Idade , Penfigoide Bolhoso/patologia , Valor Preditivo dos Testes , Pele/patologia , Adulto JovemRESUMO
BACKGROUND: Shikonin is a major active chemical component extracted from Lithospermi Radix, an effective traditional herb in various types of wound healing. Shikonin can accelerate granulomatous tissue formation by the rat cotton pellet method and induce neovascularization in granulomatous tissue. The purpose of the study was to investigate its mechanism of action in human skin cells. METHODS: MTS assay was used to measure cell growth. The collagen type I (COL1 ) mRNA expression and procollagen type I C-peptide (PIP) production were detected by real-time quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. Immunofluorescence and western blot analyses were carried out to investigate nuclear factor-κB (NF-κB) signaling pathway. Cell-based proteasome activity assay was used to determine proteasome activity. RESULTS: In this study, we found that 10 µmol/L shikonin stimulated the growth of normal human keratinocytes and 1 µmol/L shikonin promoted growth of human dermal fibroblasts. However, shikonin did not directly induce COL1 mRNA expression and PIP production in dermal fibroblasts in vitro. In addition, 1 µmol/L shikonin inhibited translocation of NF-κB p65 from cytoplasm to nucleus induced by tumor necrosis factor-α stimulation in dermal fibroblasts. Furthermore, shikonin inhibited chymotrypsin-like activity of proteasome and was associated with accumulation of phosphorylated inhibitor κB-α in dermal fibroblasts. CONCLUSIONS: These results suggested that shikonin may promote wound healing via its cell growth promoting activity and suppress skin inflammation via inhibitory activity on proteasome. Thus, shikonin may be a potential therapeutic reagent both in wound healing and inflammatory skin diseases.
Assuntos
Proliferação de Células/efeitos dos fármacos , NF-kappa B/metabolismo , Naftoquinonas/farmacologia , Complexo de Endopeptidases do Proteassoma/efeitos dos fármacos , Pele/citologia , Células Cultivadas , Ensaio de Imunoadsorção Enzimática , Fibroblastos/efeitos dos fármacos , Humanos , Queratinócitos/efeitos dos fármacos , Reação em Cadeia da PolimeraseAssuntos
ATPases Transportadoras de Cálcio/genética , Técnicas de Cultura de Células , Queratinócitos/patologia , Pênfigo Familiar Benigno/genética , Pênfigo Familiar Benigno/patologia , RNA Mensageiro/metabolismo , ATPases Transportadoras de Cálcio/metabolismo , Adesão Celular , Diferenciação Celular , Mutação da Fase de Leitura , Expressão Gênica , Técnicas de Silenciamento de Genes , Humanos , Queratinócitos/metabolismo , Masculino , Pessoa de Meia-Idade , Pênfigo Familiar Benigno/metabolismoRESUMO
BACKGROUND: Many case reports have described the coexistence of autoimmune bullous diseases (AIBDs) and psoriasis. Among them, anti-laminin γ1 (p200) pemphigoid is the best known. OBJECTIVES: We sought to characterize patients with AIBDs and psoriasis and to investigate common AIBDs occurring in these patients. METHODS: This retrospective study included 145 patients with coexisting AIBD and psoriasis given a diagnosis from January 1, 1996, to July 31, 2013, at an academic dermatology department. Of these, 134 were consultation cases regarding AIBD diagnosis. RESULTS: Ratio of male to female patients was 5.7:1. Psoriasis onset preceded AIBD onset in most patients. Mean age at AIBD onset was 65.4 years, and mean duration between psoriasis and AIBD onset was 14.6 years. Most cases had single AIBD, whereas 16 cases had combined AIBDs. Bullous pemphigoid was the most prevalent (63.4%) followed by anti-laminin γ1 pemphigoid (37.2%). LIMITATIONS: Consultation cases may not have included mild AIBD cases. CONCLUSION: This study confirmed the association of psoriasis and anti-laminin γ1 pemphigoid. However, because bullous pemphigoid is a much more common disease, it is seen more frequently in patients with psoriasis than anti-laminin γ1 pemphigoid.
Assuntos
Doenças Autoimunes/complicações , Psoríase/complicações , Dermatopatias Vesiculobolhosas/complicações , Dermatopatias Vesiculobolhosas/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosAssuntos
Transportadores de Cassetes de Ligação de ATP/genética , Araquidonato 12-Lipoxigenase/genética , Ictiose Lamelar/genética , Mutação , Povo Asiático/genética , Análise Mutacional de DNA , Frequência do Gene , Marcadores Genéticos , Predisposição Genética para Doença , Humanos , Ictiose Lamelar/diagnóstico , Ictiose Lamelar/etnologia , Japão/epidemiologia , Malásia/epidemiologia , Fenótipo , Fatores de RiscoRESUMO
In this study, we attempted to identify unknown autoantigen for intraepidermal neutrophilic IgA dermatosis-type IgA pemphigus by novel IgA-specific immunoprecipitation. Mass-spectrometry study identified polymeric immunoglobulin receptor (PIGR) as the candidate protein, and we confirmed that PIGR expressed in both epidermis and cultured keratinocytes. Eukaryotic recombinant protein of PIGR expressed in COS7 cells was reacted with both patient and normal sera, indicating that PIGR binds physiologically to IgA. To detect antigen-specific binding by IgA autoantibodies, we performed several experiments using deglycosylated PIGR and F(ab)2 fragments from patient sera. However, these analyses suggested that patient IgA bound physiologically, but not immunologically, to PIGR. Nevertheless, our study provided two important insights. Newly developed IgA-immunoprecipitation system should be a useful tool in the future study of identification of antigens for IgA autoantibodies. Detection of epidermal PIGR in this study confirmed previous results and indicated possible immunological role of PIGR in epidermis.
Assuntos
Imunoglobulina A/sangue , Imunoprecipitação/métodos , Pênfigo/imunologia , Receptores de Imunoglobulina Polimérica/sangue , Autoantígenos , Células Cultivadas , Epiderme/imunologia , Proteínas do Olho , Humanos , Queratinócitos , Neutrófilos/imunologia , Pênfigo/patologia , Fragmentos de PeptídeosRESUMO
Peroxisome proliferator-activated receptors (PPARs) are potentially useful for the treatment of skin diseases, because they stimulate keratinocyte differentiation, exert anti-inflammatory effects and improve barrier function. We examined five PPAR-γ agonists, including four thiazolidinediones (ciglitazone, troglitazone, rosiglitazone and pioglitazone) and an angiotensin-II receptor blocker (telmisartan), for their ability to upregulate filaggrin and loricrin expression at both mRNA and protein levels in cultured normal human keratinocytes (NHKs). Troglitazone, rosiglitazone, pioglitazone and telmisartan significantly increased filaggrin expression at both mRNA and protein levels in calcium-induced differentiated NHKs. Rosiglitazone and pioglitazone, but not troglitazone nor telmisartan, also significantly increased loricrin expression at both mRNA and protein levels in differentiated NHKs. These effects were not found in undifferentiated NHKs nor differentiated NHKs treated with ciglitazone. This study revealed differential effects of various PPAR-γ agonists on epidermal differentiation, and the most potent of those are rosiglitazone and pioglitazone.
Assuntos
Regulação da Expressão Gênica/efeitos dos fármacos , Proteínas de Filamentos Intermediários/química , Queratinócitos/efeitos dos fármacos , Proteínas de Membrana/química , PPAR gama/agonistas , Tiazolidinedionas/química , Anti-Inflamatórios/química , Benzimidazóis/química , Benzoatos/química , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , Cromanos/química , Proteínas Filagrinas , Humanos , Queratinócitos/citologia , Microscopia de Fluorescência , Pioglitazona , RNA Mensageiro/metabolismo , Rosiglitazona , Pele/efeitos dos fármacos , Telmisartan , TroglitazonaRESUMO
BACKGROUND: Acantholysis in pemphigus vulgaris (PV) and pemphigus foliaceus (PF) occurs predominantly in the suprabasal area and the granular layer, respectively. However, acantholysis can occasionally be observed in unusual locations. METHODS: We retrospectively studied the acantholysis locations in 35 PV and 27 PF cases, and analyzed them using the index value of Desmoglein (Dsg) 1 and Dsg3 by enzyme-linked immunosorbent assay, clinical data, and inflammatory cells. We also analyzed the relationship between clinical subtype and various parameters. RESULTS: In PV, acantholysis was noted in the suprabasal area in 3 cases, in the lower half of the epidermis in 19 cases, and throughout the epidermis in 13 cases. In PF, acantholysis was observed in the granular layer in 6 cases, in the upper half of the epidermis in 14 cases, and throughout the epidermis in 7 cases. Mean index value of Dsg1 in PV patients with acantholysis throughout the epidermis was 2-fold higher than other PV patients. Neutrophils tended to infiltrate the dermis and epidermis more in PF than in PV. CONCLUSIONS: Higher Dsg1 index values seem to correlate with acantholysis in the upper part of the epidermis in PV. Neutrophils may play some role in unusual acantholysis locations in PF.