Laboratory diagnosis of pemphigus: direct immunofluorescence remains the gold standard.

Related Articles

Laboratory diagnosis of pemphigus: direct immunofluorescence remains the gold standard.

Br J Dermatol. 2016 Jul;175(1):185-6

Authors: Giurdanella F, Diercks GF, Jonkman MF, Pas HH

PMID: 26798993 [PubMed – indexed for MEDLINE]

Posted in Br J Dermatol | Comments Off on Laboratory diagnosis of pemphigus: direct immunofluorescence remains the gold standard.

Stevens Johnson syndrome/toxic epidermal necrolysis-overlap, induced by lacosamide.

Related Articles

Stevens Johnson syndrome/toxic epidermal necrolysis-overlap, induced by lacosamide.

Eur J Dermatol. 2016 Apr 01;26(2):185-6

Authors: Kardaun SH, Vos BJ, Chandran NS

PMID: 27017922 [PubMed – indexed for MEDLINE]

Posted in Eur J Dermatol | Comments Off on Stevens Johnson syndrome/toxic epidermal necrolysis-overlap, induced by lacosamide.

Two decades of p-phenylenediamine and toluene-2,5-diamine patch testing – focus on co-sensitizations in the European baseline series and cross-reactions with chemically related substances.

Related Articles

Two decades of p-phenylenediamine and toluene-2,5-diamine patch testing – focus on co-sensitizations in the European baseline series and cross-reactions with chemically related substances.

Contact Dermatitis. 2017 Feb;76(2):81-88

Authors: Vogel TA, Heijnen RW, Coenraads PJ, Schuttelaar MA

Abstract
BACKGROUND: Cross-reactions and co-sensitizations are of great importance in understanding contact allergy and exposure sources.
OBJECTIVES: To investigate common cross-reactions and co-sensitizations in p-phenylenediamine (PPD)-sensitized and toluene-2,5-diamine (TDA)-sensitized individuals.
METHODS: From our patch test population, 8036 patients patch tested with the European baseline series were extracted. Readings had to be performed at least on day 3 according to ICDRG guidelines.
RESULTS: Two hundred and fifty-one patients were sensitized to PPD and/or TDA; 231 patients were sensitized to PPD, and 109 to TDA. Significant differences were observed regarding the strengths of patch test reactions to PPD and number of cross-reactions. For TDA, a difference was found between all reaction strengths, except between + and ++ strengths. PPD-sensitized individuals were more likely to be sensitized to carba mix, cobalt chloride, colophonium, p-tert-butyl phenolformaldehyde resin, paraben mix, and methylisothiazolinone. TDA-sensitized individuals were more often sensitized to carba mix.
CONCLUSIONS: Cross-reactivity was commonly found among individuals sensitized to PPD or TDA, and was strongly related to the strength of the patch test reaction. Regarding co-sensitizations, a frequently appearing or common exposure source could not be determined. However, modification of the allergen by, for example, the skin microbiota may have caused the formation of molecules that are, for the human immune system, indistinguishable from PPD.

PMID: 27555055 [PubMed – indexed for MEDLINE]

Posted in Contact Dermatitis | Comments Off on Two decades of p-phenylenediamine and toluene-2,5-diamine patch testing – focus on co-sensitizations in the European baseline series and cross-reactions with chemically related substances.

Immunology and genetics of tumour necrosis factor in allergic contact dermatitis.

Related Articles

Immunology and genetics of tumour necrosis factor in allergic contact dermatitis.

Contact Dermatitis. 2017 Mar 16;:

Authors: Dittmar D, Schuttelaar ML

Abstract
During the sensitization phase of allergic contact dermatitis, the proinflammatory cytokine tumour necrosis factor (TNF) plays an important role by promoting epidermal Langerhans cell migration to draining lymph nodes. It also plays a role during the elicitation phase. The TNF gene (TNF) is located within the major histocompatibility complex region. Many single-nucleotide variants exist in the promoter region of TNF, and these may either increase or decrease mRNA transcription and therefore lead to higher or lower levels of TNF. The most extensively studied single-nucleotide variant of TNF is a base pair substitution in the promoter region at location -308 relative to the transcription start site (rs1800629, TNF -308G>A), which is believed to increase transcription and lead to higher TNF levels. The role of TNF in allergic contact dermatitis and the functionality of TNF -308G>A are reviewed in this article. The association between genetic variants and disease can be studied in a case-control design. Only a few case-control studies investigating the association between TNF -308G>A and allergic contact dermatitis have been published, with contradictory results. These are reviewed critically, and suggestions for future case-control studies on this topic are given.

PMID: 28300283 [PubMed – as supplied by publisher]

Posted in Contact Dermatitis | Comments Off on Immunology and genetics of tumour necrosis factor in allergic contact dermatitis.

Acute localised exanthematous pustulosis: What are the diagnostic criteria?

Acute localised exanthematous pustulosis: What are the diagnostic criteria?

Australas J Dermatol. 2017 Feb;58(1):74

Authors: Kardaun SH

PMID: 28195325 [PubMed – in process]

Posted in Australas J Dermatol | Comments Off on Acute localised exanthematous pustulosis: What are the diagnostic criteria?

The Association between Hidradenitis Suppurativa and Crohn’s Disease: in Search of the Missing Pathogenic Link.

The Association between Hidradenitis Suppurativa and Crohn’s Disease: in Search of the Missing Pathogenic Link.

J Invest Dermatol. 2016 Sep;136(9):1747-8

Authors: van der Zee HH, Horvath B, Jemec GB, Prens EP

Abstract
Hidradenitis suppurativa is a chronic, autoinflammatory skin disease. Shalom et al. demonstrate in a large cross-sectional study an association between Crohn’s disease and hidradenitis suppurativa, but not with ulcerative colitis. This association supports the hypothesis that a similar pathogenic mechanism contributes to both diseases, providing new possibilities for functional studies and therapy development.

PMID: 27542293 [PubMed – in process]

Posted in J Invest Dermatol | Comments Off on The Association between Hidradenitis Suppurativa and Crohn’s Disease: in Search of the Missing Pathogenic Link.

Hidradenitis suppurativa: A disease of infundibular epidermis, rather than pilosebaceous units?

Hidradenitis suppurativa: A disease of infundibular epidermis, rather than pilosebaceous units?

Br J Dermatol. 2016 Aug 20;

Authors: Janse IC, Blok JL, Diercks GF, Horváth B, Jonkman MF

Abstract
although the exact pathogenesis of hidradenitis suppurativa (HS) is unknown, it is established that it is primarily an infundibulitis.(1,2) We consider infundibulum as epidermis and not as hair follicle according to Ackerman, as the type of epithelial tissue of infundibular epidermis is indistinguishable from that of interfollicular epidermis.(1) This article is protected by copyright. All rights reserved.

PMID: 27542326 [PubMed – as supplied by publisher]

Posted in Br J Dermatol | Comments Off on Hidradenitis suppurativa: A disease of infundibular epidermis, rather than pilosebaceous units?

Complement in bullous pemphigoid: results from a large observational study.

Related Articles

Complement in bullous pemphigoid: results from a large observational study.

Br J Dermatol. 2016 Jun 25;

Authors: Romeijn TR, Jonkman MF, Knoppers C, Pas HH, Diercks GF

Abstract
Bullous pemphigoid (BP) is a subepidermal autoimmune blistering disease characterized by auto-antibodies directed against the hemidesmosomal proteins 180-kDa bullous pemphigoid antigen 2 (BP180, BPAG2) and/or 230-kDa bullous pemphigoid antigen 1 (BP230, BPAG1).(1) It is thought that complement activation plays an important role in the pathogenesis of BP.(1) However, the role of complement in the formation of subepidermal blisters has been disputed and complement independent mechanisms of blister formation have been described.(2-7) However, interpretation of these data are limited since almost all studies were based on experimental pemphigoid models of mice (2,3) and human keratinocytes. (4-6) Studies assessing the role of complement in a large population of BP patients are lacking. Using a large database comprising a period of 13 years (2002-2015) we had the unique opportunity to evaluate the relation of complement with various clinical and diagnostic parameters in a large cohort of BP patients. This article is protected by copyright. All rights reserved.

PMID: 27344014 [PubMed – as supplied by publisher]

Posted in Br J Dermatol | Comments Off on Complement in bullous pemphigoid: results from a large observational study.

Contact allergy in Indonesian patients with foot eczema attributed to shoes.

Related Articles

Contact allergy in Indonesian patients with foot eczema attributed to shoes.

J Eur Acad Dermatol Venereol. 2015 Aug;29(8):1582-9

Authors: Febriana SA, Soebono H, Coenraads PJ, Schuttelaar ML

Abstract
BACKGROUND: Shoe dermatitis is a form of contact dermatitis resulting from exposure to shoes. Allergens and types of shoes responsible may vary depending on manufacturing techniques, climatic conditions and indigenous traditions. This study focuses primarily on as yet unexplored shoe dermatitis cases in Indonesia.
OBJECTIVE: To determine the prevalence of shoe dermatitis in the Dermatology outpatient clinic, Sardjito University Hospital, Yogyakarta, Indonesia over a period of 3 years and to identify the responsible allergens.
METHODS: All patients meeting screening criteria for possible shoe contact dermatitis were patch tested with the European baseline series, shoe series and additional series based on earlier studies of Indonesian leather and shoe manufacturers; some were also patch tested with their own shoe materials and shoe extracts.
RESULTS: Sixty-four (7.1%) of 903 patients with foot skin disorders were diagnosed with shoe dermatitis. Twenty-five (52.1%) of 48 patch-tested patients showed positive reactions to one or more allergens related to footwear. Sixteen patients were patch tested with their own shoe materials; 11 showed positive reactions. The most frequent relevant sensitizers were rubber allergens followed by preservatives, shoe adhesives and leather materials.
CONCLUSION: Shoe dermatitis is common in Indonesia. Using three series of patch tests, we identified responsible allergens and patterns of sensitization in Indonesian shoe dermatitis patients.

PMID: 25640221 [PubMed – indexed for MEDLINE]

Posted in J Eur Acad Dermatol Venereol | Comments Off on Contact allergy in Indonesian patients with foot eczema attributed to shoes.

Current practice in treatment approach for bullous pemphigoid: comparison between national surveys from the Netherlands and the UK.

Related Articles

Current practice in treatment approach for bullous pemphigoid: comparison between national surveys from the Netherlands and the UK.

Clin Exp Dermatol. 2016 Mar 4;

Authors: Meijer JM, Jonkman MF, Wojnarowska F, Wiliams HC, Kirtschig G

Abstract
Treatment approaches for bullous pemphigoid (BP), the most common autoimmune skin blistering disease, are largely based on national and international guidelines. We conducted a national survey among dermatologists in the Netherlands to explore the current treatment of BP, and compared the results with those of a previously published survey from the UK. Almost all responders in the Netherlands (n = 175) used very potent topical corticosteroids, both as monotherapy and as adjunctive therapy. In contrast to UK dermatologists, the majority recommended whole-body application rather than local application to lesions. Systemic antibiotics were used by > 70% of responders. Half of the responders in the Netherlands considered systemic steroids the first-choice treatment, with the majority also using adjunctive therapy as a routine. Despite many similarities in treatment approach between the two countries, these surveys provide an important insight into the gap between actual and recommended practice at a country level in relation to the best external evidence.

PMID: 26940484 [PubMed – as supplied by publisher]

Posted in Clin Exp Dermatol | Comments Off on Current practice in treatment approach for bullous pemphigoid: comparison between national surveys from the Netherlands and the UK.

Blistering disease: insight from the hemidesmosome and other components of the dermal-epidermal junction.

Related Articles

Blistering disease: insight from the hemidesmosome and other components of the dermal-epidermal junction.

Cell Tissue Res. 2015 Jun;360(3):545-69

Authors: Turcan I, Jonkman MF

Abstract
The hemidesmosome is a specialized transmembrane complex that mediates the binding of epithelial cells to the underlying basement membrane. In the skin, this multiprotein structure can be regarded as the chief adhesion unit at the site of the dermal-epidermal junction. Focal adhesions are additional specialized attachment structures located between hemidesmosomes. The integrity of the skin relies on well-assembled and functional hemidesmosomes and focal adhesions (also known as integrin adhesomes). However, if these adhesion structures are impaired, e.g., as a result of circulating autoantibodies or inherited genetic mutations, the mechanical strength of the skin is compromised, leading to blistering and/or tissue inflammation. A particular clinical presentation emerges subject to the molecule that is targeted. None of these junctional complexes are simply compounds of adhesion molecules; they also play a significant role in signalling pathways involved in the differentiation and migration of epithelial cells such as during wound healing and in tumour invasion. We summarize current knowledge about hereditary and acquired blistering diseases emerging from pathologies of the hemidesmosome and its neighbouring proteins as components of the dermal-epidermal junction.

PMID: 25502077 [PubMed – indexed for MEDLINE]

Posted in Cell Tissue Res | Comments Off on Blistering disease: insight from the hemidesmosome and other components of the dermal-epidermal junction.

Assessment of the elicitation response in subjects weakly sensitized to p-phenylenediamine.

Related Articles

Assessment of the elicitation response in subjects weakly sensitized to p-phenylenediamine.

Br J Dermatol. 2015 Jan;172(1):138-44

Authors: Pot LM, Coenraads PJ, Goebel C, Blömeke B

Abstract
BACKGROUND: A 30-min application of a hair dye product containing 2% p-phenylenediamine (PPD) to subjects diagnostically graded +, showed that 12 of 18 reacted; eight of 18 with a true + and four of 18 with a doubtful (?+) response, whereas six of 18 did not react at all. In vitro skin-binding experiments showed that for diagnostic patch test conditions the measured exposure level (MEL) is more than 10-fold higher than the MEL for hair dyeing conditions.
OBJECTIVE: To further analyse the limited elicitation response of the diagnostically + graded subjects to a PPD hair dye product, under standardized test conditions mimicking product usage, by varying exposure time and dose.
METHODS: A hair dye model formulation containing 2% PPD, applied for 30, 45 and 60 min and a diagnostic PPD TRUE test(®) were applied to assess elicitation responses to increasing PPD exposure levels. Grading was performed according to International Contact Dermatitis Research Group guidelines.
RESULTS: Six subjects were available for this follow-up study. One of six subjects responded with a + elicitation response to the hair dye model applied for 60 min. Four of the five remaining subjects elicited a + response to the PPD TRUE test(®) applied subsequently, while one of five responded doubtfully.
CONCLUSIONS: Increasing the PPD exposure time twofold–resulting in a 5-6% increase of sensitivity of this hair dye model test–or further extending the exposure time 48-fold, was found sufficient to increase the MEL above the thresholds needed to elicit individuals with a + diagnostic PPD patch test who did not react to typical hair dye use conditions with a MEL of about 6·8 ?g cm?². This analysis confirms that consideration of the MEL is a useful tool to better characterize thresholds of elicitation than consideration of the applied dose alone.

PMID: 24890083 [PubMed – indexed for MEDLINE]

Posted in Br J Dermatol | Comments Off on Assessment of the elicitation response in subjects weakly sensitized to p-phenylenediamine.

p-Phenylenediamine exposure in real life?-?a case-control study on sensitization rate, mode and elicitation reactions in the northern Netherlands.

Related Articles

p-Phenylenediamine exposure in real life?-?a case-control study on sensitization rate, mode and elicitation reactions in the northern Netherlands.

Contact Dermatitis. 2015 Jun;72(6):355-61

Authors: Vogel TA, Coenraads PJ, Bijkersma LM, Vermeulen KM, Schuttelaar ML, EDEN Fragrance Study Group

Abstract
BACKGROUND: The prevalence of p-phenylenediamine (PPD) sensitization is 4% in the patch tested population and varies between zero and 1.5% in the general population. Hair dye is a recognised sensitization source.
OBJECTIVES: To define the prevalence rates of PPD sensitization in the general and patch tested populations of The Netherlands, and to gain insights into relationships between patch test strength and exposure sources.
METHODS: Patch test database cases were matched with population-based controls. Analyses were performed based on demographic details, patch test reactions, and potential PPD exposure.
RESULTS: PPD sensitization occurred in 3.3% of the patch tested population and in 1.3% of the general population. Hairdressers had a 4.4-fold increased chance of being sensitized to PPD (p?=?0.041), and black henna tattoos showed a tendency for a 2.3-fold increased chance of sensitization (p?=?0.081). Weak elicitation reactions were present in hairdressers and consumers. However, cases who had had black henna tattoos showed significantly more (extremely) strong patch test reactions upon elicitation (p?=?0.015).
CONCLUSIONS: The prevalence rates in the patch tested and general population of The Netherlands are comparable with the prevalence rates of other mid-European centres. PPD sensitization is often attributed to hair dye. However, this study shows that subjects sensitized by black henna tattoos present with very severe elicitation reactions, emphasizing the need for more strict policing the prohibition.

PMID: 25824090 [PubMed – indexed for MEDLINE]

Posted in Contact Dermatitis | Comments Off on p-Phenylenediamine exposure in real life?-?a case-control study on sensitization rate, mode and elicitation reactions in the northern Netherlands.

Atypical presentation of painful vesicles on the hands and feet in an immunocompromised adult.

Related Articles

Atypical presentation of painful vesicles on the hands and feet in an immunocompromised adult.

J Clin Virol. 2015 Nov 17;

Authors: Christoffers WA, Riezebos-Brilman A, Kardaun SH

PMID: 26830876 [PubMed – as supplied by publisher]

Posted in J Clin Virol | Comments Off on Atypical presentation of painful vesicles on the hands and feet in an immunocompromised adult.

Epiplakin Is a Paraneoplastic Pemphigus Autoantigen and Related to Bronchiolitis Obliterans in Japanese Patients.

Related Articles

Epiplakin Is a Paraneoplastic Pemphigus Autoantigen and Related to Bronchiolitis Obliterans in Japanese Patients.

J Invest Dermatol. 2016 Feb;136(2):399-408

Authors: Tsuchisaka A, Numata S, Teye K, Natsuaki Y, Kawakami T, Takeda Y, Wang W, Ishikawa K, Goto M, Koga H, Sogame R, Ishii N, Takamori S, Hoshino T, Brandt O, Pas HH, Fujiwara S, Hashimoto T

Abstract
All plakin family proteins are known to be autoantigens in paraneoplastic pemphigus (PNP). In this study, we first examined whether PNP sera also react with epiplakin, another plakin protein, by various immunological methods using 48 Japanese PNP sera. Immunofluorescence confirmed that cultured keratinocytes expressed epiplakin. Epiplakin was detected by 72.9% of PNP sera by immunoprecipitation-immunoblotting with KU-8 cell extract, but not by immunoblotting of either normal human epidermal extract or KU-8 cell extract. Epiplakin was essentially not detected by 95 disease and normal control sera. Statistical analyses of various clinical and immunological findings revealed a significant correlation of the presence of anti-epiplakin antibodies with both bronchiolitis obliterans and mortality. No epiplakin-negative PNP case developed bronchiolitis obliterans. However, although 29.4% of European patients with PNP had bronchiolitis obliterans, significant correlation with anti-epiplakin autoantibodies was not observed. In further studies for lung, immunofluorescence showed the presence of epiplakin in normal human lung, particularly respiratory bronchiole, immunoprecipitation-immunoblotting showed that PNP sera reacted with epiplakin in cultured lung cells, and mice injected with polyclonal antibody specific to epiplakin histopathologically showed abnormal changes in small airway epithelia. These results indicated that epiplakin is one of the major PNP autoantigens and is related to PNP-related bronchiolitis obliterans.

PMID: 26802236 [PubMed – as supplied by publisher]

Posted in J Invest Dermatol | Comments Off on Epiplakin Is a Paraneoplastic Pemphigus Autoantigen and Related to Bronchiolitis Obliterans in Japanese Patients.