{"title":"Genetic associations of human leukocyte antigen alleles in cutaneous delayed drug hypersensitivity reactions: An updated review","authors":"Chun-Bing Chen, Chih-Chun Lee, Chuang-Wei Wang, Wei-Kai Hung, Wen-Hung Chung","doi":"10.4103/ds.ds-d-23-00082","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00082","url":null,"abstract":"<p>Cutaneous delayed drug hypersensitivity reactions (DHRs) are common iatrogenic events with potentially life-threatening consequences. Delayed DHRs encompass diverse phenotypes and can be classified by their distinct T-cell responses to drug antigens. Interaction between the immune receptors, human leukocyte antigen (HLA) and T-cell receptor (TCR), and the complementary antigenic peptide is required for the development of delayed DHRs. These idiosyncratic interactions can be elicited by the formation of antigenic drug-protein adducts (hapten hypothesis) or from direct interactions of drugs with the immune receptors (pharmacological interaction of drugs with immune receptors concept, altered peptide repertoire model, and altered TCR model). In addition, viral infections may play a role by providing co-stimulatory signals or enhancing TCR/HLA expression on T-cells. The associations of HLA allele polymorphisms and DHRs are phenotype and ethnicityspecific. The discovery of genetic polymorphisms associated with DHRs has provided a strategy to prevent and diagnose potentially life-threatening reactions. Recently, advances in next-generation sequencing technologies, such as the incorporation of whole-exome or whole-genome sequencing, enabled the comprehensive detection of susceptibility loci. Several HLA associations have shown clinical utility and cost-effectiveness, such as HLA-B*15:02 (carbamazepine-induced Stevens–Johnson syndrome/toxic epidermal necrolysis in Han Chinese), HLA-B*58:01 (allopurinol-induced severe cutaneous adverse reactions in Han Chinese), HLA-B*57:01 (abacavir hypersensitivity reactions in Caucasians), and HLA-B*13:01 (dapsone-induced drug reaction with eosinophilia and systemic symptoms in Han Chinese). Herein, we summarize the current knowledge of the pathogenesis, antigen presentation models, and HLA associations of cutaneous delayed DHRs.</p>","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139070223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Levels of evidence and study designs: A brief introduction to dermato-epidemiologic research methodology","authors":"Yen-Ning Chen, Ching-Chi Chi*","doi":"10.4103/ds.ds-d-23-00159","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00159","url":null,"abstract":"\u0000 Levels of evidence (LOE), also known as hierarchies of evidence, are determined primarily by the inherent bias and validity of the study designs. Understanding LOE is a crucial preliminary step in practicing evidence-based medicine (EBM) or evidence-based dermatology. These hierarchies facilitate the efficient acquisition of the best available evidence for clinicians in decision-making, as well as guiding researchers in conducting new studies with appropriate designs while considering the next higher LOE necessary to improve the quality of currently available evidence. This article provides a concise overview of LOE and study designs based on the 2011 Oxford Centre for Evidence-Based Medicine LOE for treatment benefits. We utilize examples from medical literature to elucidate the strengths and limitations of various study designs. Furthermore, we shed light on the key concepts of the updated evidence pyramid and how the EBM research roadmap functions to bridge the gap between current best evidence and clinical practice.","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nattan Stalin, Dongyup Lee, Amitesh Sharma, Shivani Devi, Jiwon Choi, Yunbhin Hwang, Young Sil Kim, Tae-Sik Park*
{"title":"Membrane-free stem cell components ameliorate atopic dermatitis in 2,4-dinitrochlorobenzene-induced NC/Nga mice","authors":"Nattan Stalin, Dongyup Lee, Amitesh Sharma, Shivani Devi, Jiwon Choi, Yunbhin Hwang, Young Sil Kim, Tae-Sik Park*","doi":"10.4103/ds.ds-d-23-00070","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00070","url":null,"abstract":"\u0000 \u0000 \u0000 Atopic dermatitis (AD) is a prevalent inflammatory skin disorder characterized by skin barrier dysfunction, thymic stromal lymphopoietin (TSLP) production and an imbalance in the Th1/Th2 immune response. While numerous studies have examined the therapeutic potential of adipose-derived stem cells (ADSC) in repairing and regenerating damaged skin tissues caused by AD, the effects of membrane-free stem cell components derived from ADSC extract (ADSCE) on AD have not been investigated.\u0000 \u0000 \u0000 \u0000 The objective of this study was to investigate the alleviating effects of ADSCE on AD in mice and validate the therapeutic application of ADSCE on AD.\u0000 \u0000 \u0000 \u0000 An AD-like lesion was induced by the administration of 2,4-dinitrochlorobenzene (DNCB) on the dorsal skin of NC/Nga mice. Then, ADSCE was administered subcutaneously for 3 weeks. Dermatitis score, epidermal thickness, transepidermal water loss (TEWL), and serum levels of immunoglobulin E (IgE) were measured. Expression of the skin barrier proteins and inflammatory cytokines were measured by western blotting and quantitative real-time polymerase chain reaction.\u0000 \u0000 \u0000 \u0000 The administration of ADSCE demonstrated a significant amelioration in several skin diseases, as indicated by improvements in dermatitis score, epidermal thickness, TEWL, and total blood levels of IgE. ADSCE treatment led to an upregulation in the expression of various skin barrier proteins, including involucrin, loricrin, occludin, and zonula occludens-1. In addition, ADSCE inhibited the infiltration of mast cells and the expression of TSLP. Expression of inflammatory cytokines, including tumor necrosis factor-α, interleukin (IL)-1 β, IL-4, and inducible nitric oxide synthase, was also lowered by ADSCE.\u0000 \u0000 \u0000 \u0000 The use of ADSCE resulted in enhanced skin features and exerted anti-inflammatory properties on AD-like lesions in mice.\u0000","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138996600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caroline Oktarina, R. Astriningrum, Aida S. D. Hoemardani, W. Budianti, Sandra Widaty, Dewi Friska
{"title":"Hand eczema and its severity in nonmedical personnel: A study of the use of hand sanitizer on transepidermal water loss and skin capacitance","authors":"Caroline Oktarina, R. Astriningrum, Aida S. D. Hoemardani, W. Budianti, Sandra Widaty, Dewi Friska","doi":"10.4103/ds.ds-d-23-00143","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00143","url":null,"abstract":"\u0000 \u0000 \u0000 An increased frequency of hand sanitizer use and washing hands with soap seems to increase the incidence of hand eczema (HE).\u0000 \u0000 \u0000 \u0000 The aim was to analyze HE in nonmedical personnel, its severity, and the effect of hand sanitizer use on transepidermal water loss (TEWL) and skin capacitance.\u0000 \u0000 \u0000 \u0000 This observational cross-sectional study was conducted from July to September 2022. Subjects were recruited based on the study criteria with cluster random sampling method. Each subject’s identity, data related to hand sanitizer use and handwashing, atopic stigmata, and duration of HE were documented. The severity of HE was assessed with the HE Severity Index (HECSI). TEWL and skin capacitance were measured with the Tewameter® TM 300 and Corneometer® CM 825 instruments.\u0000 \u0000 \u0000 \u0000 Out of 240 subjects who were selected randomly, 24 normal subjects and 24 subjects with HE were recruited. The incidence of HE in nonmedical personnel using hand sanitizer was 10%, with a median disease duration of 22 weeks and a mean HECSI score of 9.25 ± 6.33. There was no significant difference in TEWL and skin capacitance between the groups (P > 0.05). There was no significant correlation between TEWL and skin capacitance with the HECSI score (P > 0.05). Subjects with HE washed their hands more frequently than subjects without HE (6 vs. 4.5 times per day; P 0.005).\u0000 \u0000 \u0000 \u0000 Most nonmedical personnel with HE had a mild form of the condition. There were no significant barrier function and skin hydration differences between the groups.\u0000","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yukari Woo, Suyeun Kim, Sang Hyun Cho, Hei Sung Kim
{"title":"Rosacea understanding among Korean patients: A multi-center questionnaire study","authors":"Yukari Woo, Suyeun Kim, Sang Hyun Cho, Hei Sung Kim","doi":"10.4103/ds.ds-d-23-00145","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00145","url":null,"abstract":"\u0000 \u0000 \u0000 Rosacea is a common chronic skin condition. To manage rosacea long-term and prevent further flare-ups, patients need to be aware of the disease and have sound knowledge of the condition. However, few related studies have been conducted on this subject.\u0000 \u0000 \u0000 \u0000 The aim of this study was to identify rosacea awareness and knowledge among Korean rosacea patients and their means of gathering information on the disease.\u0000 \u0000 \u0000 \u0000 A prospective multicenter cross-sectional study recruited a total of 201 outpatients who were diagnosed with rosacea by a dermatologist. All were asked to complete a questionnaire asking about their demographic characteristics, rosacea awareness, and knowledge.\u0000 \u0000 \u0000 \u0000 Among 201 rosacea patients, 146 (72.6%) were unaware of the disease before their diagnosis. The median number of questions the patients correctly answered was 6 of a total of 13 questions (46%) on rosacea knowledge, implying relatively shallow knowledge on rosacea. Better understanding of rosacea was negatively associated with age (odds ratio [OR] 0.965; 95% confidence interval [CI]: 0.941 – 0.989) and positively associated with a higher education level (OR = 2.896; 95% CI: 1.379–6.082). Individuals with rosacea felt that they were getting reliable information from doctors (n = 189, 94%), followed by the Internet (n = 38, 18.9%).\u0000 \u0000 \u0000 \u0000 Overall, rosacea awareness and knowledge among Korean rosacea patients were relatively low. Detailed education, especially targeting elderly patients and those with low education levels, is necessary for better disease outcomes.\u0000","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Upadacitinib for the treatment of alopecia areata – A case report","authors":"Jui-Wen Yeh, Chao-Chun Yang","doi":"10.4103/ds.ds-d-23-00110","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00110","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139199777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk of thyroid cancer among patients with vitiligo: A systematic review and meta-analysis","authors":"Yi-Rong Li, Ting-An Chang, Jen-Hung Wang, Li-Yu Chen, Jing-Wun Lu, Ching-Hui Loh, Tai-Li Chen","doi":"10.4103/ds.ds-d-23-00089","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00089","url":null,"abstract":"<h3>Background: </h3>\u0000<p>Whether patients with vitiligo have an increased risk of thyroid cancer remained controversial.</p>\u0000<h3>Objectives: </h3>\u0000<p>To study the risk of developing thyroid cancer among vitiligo patients using meta-analysis.</p>\u0000<h3>Methods: </h3>\u0000<p>This meta-analysis was performed via a literature review of four databases (Web of Science, Embase, PubMed, and Cochrane Library) from their respective inception till February 17, 2023. Relevant reviews and the bibliographies of eligible studies were also scrutinized. During searching in databases, no filter was placed regarding the language or geography of the study. Only observational studies presenting with adjusted risk estimates were eligible for meta-analysis. The random-effects model was employed for performing this meta-analysis.</p>\u0000<h3>Results: </h3>\u0000<p>Four studies with 200,629 vitiligo patients and 404,124 nonvitiligo controls were included in this meta-analysis, and patients with vitiligo were found to have an elevated risk of thyroid cancer (pooled relative risk, 1.341; 95% confidence interval, 1.083–1.661).</p>\u0000<h3>Conclusion: </h3>\u0000<p>Our systematic review and meta-analysis found that vitiligo patients are at a slightly elevated risk of thyroid cancer, although the exact underlying mechanisms remain unclear. Even though the evidence is limited, clinicians should not ignore the possible susceptibility of developing thyroid malignancy among vitiligo patients.</p>","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139070019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment responses of four different biologics in a patient with recurrent generalized pustular psoriasis harboring IL36RN mutation","authors":"Chang-Yu Hsieh, Tsen-Fang Tsai","doi":"10.4103/ds.ds-d-23-00107","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00107","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139247218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anatomical distribution of basal cell carcinoma and squamous cell carcinoma in the Taiwanese population","authors":"Hsin-Yu Huang, Chao-Chun Yang","doi":"10.4103/ds.ds-d-23-00075","DOIUrl":"https://doi.org/10.4103/ds.ds-d-23-00075","url":null,"abstract":"","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}