Atopic dermatitis phenotypes and the need for personalized medicine.

Purpose of review: To describe recent developments in therapies which target the molecular mechanisms in atopic dermatitis. Recent findings: Current advances in the understanding of the molecular basis of atopic dermatitis are leading to the stratification of different atopic dermatitis phenotypes. New therapies offer the option to target-specific molecules involved in the pathophysiology of atopic dermatitis. Current new therapies under investigation aim to modulate specific inflammatory pathways associated with distinctive atopic dermatitis phenotypes, which would potentially translate into the development of personalized, targeted-specific treatments of atopic dermatitis. Summary: Despite the unmet need for well tolerated, effective, and personalized treatment of atopic dermatitis, the current standard treatments of atopic dermatitis do not focus on the individual pathogenesis of the disease. The development of targeted, phenotype-specific therapies has the potential to open a new promising era of individualized treatment of atopic dermatitis. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Atopic dermatitis phenotypes and the need for personalized medicine.

Purpose of review: To describe recent developments in therapies which target the molecular mechanisms in atopic dermatitis. Recent findings: Current advances in the understanding of the molecular basis of atopic dermatitis are leading to the stratification of different atopic dermatitis phenotypes. New therapies offer the option to target-specific molecules involved in the pathophysiology of atopic dermatitis. Current new therapies under investigation aim to modulate specific inflammatory pathways associated with distinctive atopic dermatitis phenotypes, which would potentially translate into the development of personalized, targeted-specific treatments of atopic dermatitis. Summary: Despite the unmet need for well tolerated, effective, and personalized treatment of atopic dermatitis, the current standard treatments of atopic dermatitis do not focus on the individual pathogenesis of the disease. The development of targeted, phenotype-specific therapies has the potential to open a new promising era of individualized treatment of atopic dermatitis. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2rZd1R3

Severe erythematotelangiectatic rosacea with cold wave-induced epidermal necrosis treated with carvedilol combined with brimonidine gel

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Curcumin for the treatment of tumor-stage mycosis fungoides

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Delayed onset filler complication: Two case reports and literature review

Abstract

Soft tissue augmentation by fillers has become a popular cosmetic tool to offer rejuvenation and aesthetic improvement. Its results are comparable to those previously achieved only by plastic surgery. However, marked increase of filler procedures is associated with a great number of complications. Complications associated with filler injection might have early onset (within days) or late onset (after weeks to years). Delayed complications include infections, foreign body granulomatous reaction, migration of filler material, persistent discoloration, and scarring. Here we report two cases of delayed complications: one case of foreign body granuloma with migration and one case of acute inflammation involving a quiescent granuloma.

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New Method for Sex Prediction Using the Human Non-Adult Auricular Surface of the Ilium in the Collection of Identified Skeletons of the University of Coimbra

Abstract

Sex estimation in non-adult skeletons is crucial in bioarchaeology and forensic anthropology. It was not extensively considered in the past, mainly because it was stated that the dimorphic osteological features were difficult to identify before adulthood. Over the past few years, this statement was disproved, and the study of numerous dimorphic non-adult skeletal traits was approached. This paper presents a new methodology that evaluates the auricular surface of the non-adult ilia. Several morphological and continuous variables were recorded for 34 individuals (21 females and 13 males) aged between 7 and 18 from the Coimbra Identified Skeletons Collection (University of Coimbra, Portugal).

The results show low intra and inter-observer errors for all the variables, which renders the methodology replicable. Two ratios related to the shape of the anterior area of the auricular surface offer the most dimorphic data (proportions of cases correctly assigned: 0.82 and 0.88; sexual allocation probabilities: 0.85 for both variables). A discriminant function and a logistic regression were developed, which correctly classified the 82.35 and the 88.23% of the individuals, respectively. Moreover, two qualitative variables, referred to as the overall morphology and the apex morphology, also show statistically significant differences between males and females (proportions of correct assignation: 0.82 and 0.76; sexual allocation probabilities: 0.79 and 0.76).

These variables can be incorporated in a multifactorial approach together with other indicators already available in the specialised literature in order to help improve the accuracy of the results obtained. This methodological procedure has to be applied with other identified samples, including younger individuals, so as to test whether the trends presented in this context are maintained and are useful in populations from a different geographical provenience.

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Functional and phenotypic analysis of basophils allows determining distinct subtypes in patients with chronic urticaria

Abstract

Background

Chronic urticaria (CU) is a frequent skin disease characterized by relapsing appearance of pruritic hives. While clinical symptoms are due to the release of histamine by cutaneous mast cells, the underlying pathophysiology is still unknown. However, previous studies indicate that basophils might be of relevance. Besides, the occurrence of autoantibodies against IgE or its receptor, FcεRI, and the therapeutic efficacy of anti-IgE antibodies imply that IgE-mediated mechanisms also play an important role in CU.

Methods

Reactivity of CU patients' peripheral blood basophils (n=60) to specific anti-FcεRI and IgE-independent fMLP stimulation was determined by basophil activation test in comparison to patients suffering from IgE-mediated allergic rhinitis (n=10) and healthy controls (n=10). In addition, immunoglobulin receptor (FcεRI, FcγRII) expression and surface bound antibodies (IgE, IgG) were quantified on basophils. Furthermore, the autoreactive capacity of CU sera was evaluated and urticaria-related symptoms were assessed by both UCT and CU-Q₂oL.

Results

Stimulating CU patients' basophils via FcεRI, we identified three distinct immunological phenotypes. One subgroup of patients' basophils reacted to FcεRI stimulation, whereas the others had anti-FcεRI non-reactive basophils. Among the latter a subgroup with pronounced basopenia was identified. Of note, this group was characterized by augmented serum-induced basophil activation, increased levels of autoantibodies against thyroid peroxidase and also exhibited the strongest disease impact on their quality of life.

Conclusions

CU patients can be categorized into three immunological subgroups based on their basophil reactivity and frequency. These phenotypes are associated with different clinical characteristics, pointing to basophils as important players in CU pathophysiology.

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