Category Archives: Br J Dermatol

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The value of ongoing surveillance on the prevalence of contact sensitization.
Br J Dermatol. 2020 May 26;:
Authors: Schuttelaar MLA
PMID: 32458421 [PubMed – as supplied by publisher]

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Obituary: Professor Marcel F. Jonkman: 1957-2019.

Br J Dermatol. 2019 Sep;181(3):643-644

Authors: Horváth B, Bolling MC, Steijlen PM

PMID: 31475344 [PubMed – in process]

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Responsiveness and interpretability of the Hand Eczema Severity Index (HECSI).

Br J Dermatol. 2019 Jul 01;:

Authors: Oosterhaven JAF, Schuttelaar MLA

Abstract
BACKGROUND: The Hand Eczema Severity Index (HECSI) is used to measure severity of hand eczema. It is unclear what HECSI scores mean and what is the minimally important change (MIC). Furthermore, responsiveness has not been studied.
OBJECTIVES: To study responsiveness and interpretability of the HECSI.
METHODS: Prospective study covering two time points; baseline and after 4-12 weeks. Responsiveness was assessed using a criterion approach with a ≥ 1 step improvement on the ‘Photographic guide for severity of hand eczema’ as anchor for important improvement. Interpretability of single scores was determined by defining severity bands based on agreement with the anchor. For change scores, smallest detectable change (SDC) was calculated in unchanged patients and MIC was obtained in changed patients using three methods: mean cut-off, receiver operating curve (ROC) and 95%-limit.
RESULTS: N=294 patients participated (N=160 males, mean age 44·9). HECSI scores improved/deteriorated in parallel with the anchor. The area under the ROC curve was 0·86 (95% confidence interval: 0·81-0·91). The final severity band for single scores had a κ-coefficient of agreement of 0·694: clear, 0; almost clear, 1-16; moderate, 17-37; severe, 38-116; very severe, ≥117. The SDC in N=93 unchanged patients was 40·3 points. The obtained MIC values were all smaller than the SDC.
CONCLUSIONS: The HECSI has good responsiveness. This study gives meaning to HECSI scores, which can be applied to clinical decision making and the design of clinical trials. We recommend that an improvement of 41 points on the HECSI is regarded as minimally measurable true change. This article is protected by copyright. All rights reserved.

PMID: 31260086 [PubMed – as supplied by publisher]

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Response to ‘Serological diagnostics in the detection of IgG autoantibodies against human collagen VII in epidermolysis bullosa acquisita: a multicentre analysis’.
Br J Dermatol. 2018 02;178(2):573
Au… Continue reading →

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Complete remission of skin lesions in a patient with subcorneal pustular dermatosis (Sneddon-Wilkinson disease) treated with antimyeloma therapy: association with disappearance of M-protein.
Br J Dermatol. 20… Continue reading →

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Image Gallery: Paraneoplastic pemphigus and follicular dendritic cell sarcoma.
Br J Dermatol. 2018 Feb;178(2):e146
Authors: Jonkman MF, Pas HH
PMID: 29441554 [PubMed – in process]

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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: 26798… Continue reading →

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]

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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… Continue reading →

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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 μg 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]

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Continuous usage of a hair dye product containing 2-methoxymethyl-p-phenylenediamine by hair dye allergic individuals.

Br J Dermatol. 2016 Jan 8;

Authors: Kock M, Coenraads PJ, Blömeke B, Goebel C

Abstract
BACKGROUND: Despite a positive patch test reaction to p-phenylenediamine (PPD) and/or toluene-2,5-diamine (PTD) many people attempt to continue dyeing their hair with products containing PPD or its derivatives.
OBJECTIVES: Investigation of elicitation reactions among PPD/PTD allergic individuals to hair dye products containing the less-sensitizing PPD-derivative 2-methoxymethyl-p-phenylenediamine (ME-PPD).
METHODS: Elicitation reactions were studied in 43 PPD/PTD allergic individuals by a 45-min pre-test with a ME-PPD containing hair dye on their forearm and upon negative result followed by exposure to subsequent hair colour treatment(s).
RESULTS: 38/43 PPD/PTD allergic individuals did not develop an elicitation reaction during the pre-test with ME-PPD containing hair dye products and were eligible for subsequent hair colour treatments. Of these 38 PPD/PTD allergic individuals 29 tolerated subsequent hair dyeing with ME-PPD containing hair dye products while 9 showed mild to moderate allergic reactions upon the first hair colour treatment.
CONCLUSIONS: Hair dye products with the less sensitizing ME-PPD were tolerated by 29/43 (67%) PPD/PTD allergic individuals throughout continued hair dyeing with an average of 9 treatments per year. Five individuals reacted upon pre-testing while only mild to moderate skin reactions occurred upon hair dyeing in 9 individuals who were not identified by the pre-test. To our knowledge this is the first study among PPD/PTD allergic individuals indicating that a negative 45 min pre-testing with a hair dye product helps to avoid severe allergic reactions. This article is protected by copyright. All rights reserved.

PMID: 26749506 [PubMed – as supplied by publisher]

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Somatic mosaicism for the COL7A1 mutation p.Gly2034Arg in the unaffected mother of a patient with dystrophic epidermolysis bullosa pruriginosa.
Br J Dermatol. 2015 Mar;172(3):778-81
Authors: van den … Continue reading →

Ustekinumab in hidradenitis suppurativa: clinical results and a search for potential biomarkers in serum.

Br J Dermatol. 2015 Dec 7;

Authors: Blok JL, Li K, Brodmerkel C, Horvátovich P, Jonkman MF, Horváth B

Abstract
BACKGROUND: Treatment of hidradenitis suppurativa (HS) is difficult and the search for effective therapies continues.
OBJECTIVES: 1.To evaluate the efficacy of ustekinumab. 2.To discover a potential biomarker.
METHODS: Seventeen patients were included in this open label study and treated with 45 to 90 mg ustekinumab at weeks 0, 4, 16 and 28. Proteomic technology and enzyme-linked assay analysis (ELISA) was applied on serum.
RESULTS: Twelve patients completed the protocol. Moderate to marked improvement of the modified Sartorius Score was achieved in 82% of patients at week 40 and the hidradenitis suppurativa clinical response (HiSCR-50) in 47%. At baseline, a significant difference was observed in the expression of 54 serum proteins between patients and healthy controls. Involved pathways were related to inflammation, immune cell signaling, and tissue morphology/development. Good responders had milder disease and lower expression of leukotriene A4-hydrolase (LTA4H). IL-2R, TNF-α, IL17A and IL-17F were not elevated and did not change during treatment.
CONCLUSIONS: The majority of patients improved with ustekinumab. Although no biomarker was discovered, low LTA4H concentrations with mild disease severity may be predictive for the effectiveness of ustekinumab. This article is protected by copyright. All rights reserved.

PMID: 26641739 [PubMed – as supplied by publisher]

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Prevalence of contact allergy in the general population in different European regions.

Br J Dermatol. 2015 Sep 15;

Authors: Diepgen TL, Ofenloch RF, Bruze M, Bertuccio P, Cazzaniga S, Coenraads PJ, Elsner P, Goncalo M, Svensson Å, Naldi L

Abstract
BACKGROUND: Population-based studies about contact allergy are scarce.
OBJECTIVES: To obtain reliable estimates of prevalence of contact allergy in the general population in Europe.
METHODS: Cross-sectional study of a random sample from the general population, aged 18 to 74 years, in 5 different European countries (Sweden, The Netherlands, Germany, Italy, Portugal). In total 12,377 subjects were interviewed and a random sample (n=3,119) patch tested to TRUE-test panel 1, 2 and 3 plus fragrance mix II, HICC, and sesquiterpene lactone mix. A positive patch test reaction is considered as contact allergy.
RESULTS: In total, 27.0% (95% CI 25.5-28.5) had at least one positive reaction to an allergen of the European baseline series with a significant higher prevalence in females compared to males. The highest age-standardized prevalences (≥ 1%) were found for nickel (14.5%; 95% CI 13.2-15.8), thimerosal (5.0%; 95% CI 4.2-5.8), cobalt (2.2%; 95% CI 1.7-2.7), fragrance mix II (1.9%, 95% CI 1.5-2.5), fragrance mix I (1.8% 95% CI 1.4-2.3), hydroxyisohexyl-3-cyclohexene carboxaldehyde (HICC)(1.4%, 95% CI 1.0-1.9), p-tert-butylphenol- formaldehyde-resin (1.3%; 95% CI 0.9-1.7), and p-phenylenediamine (1.0%; 95% CI 0.6-1.3). Only Nickel and Thimerosal showed a statistically significant different prevalence for contact allergy amongst the different European populations. Subjects that reported contact dermatitis in lifetime (age-standardized prevalence 15.1%, 95%CI 13.8-16.3) had an increased risk for contact allergy (OR 1.9, 95% CI 1.5-2.5) the risk of having a contact allergy was not increase in those with atopic dermatitis (prevalence 7.6%, 95% CI 6.7-8.6; OR 1.0, 95% CI 0.7-1.4).
CONCLUSIONS: Contact allergy to at least one allergen of the European baseline series was diagnosed in more than one quarter of the general European population. Therefore measures to improve the primary prevention of contact allergy have to be enforced. This article is protected by copyright. All rights reserved.

PMID: 26370659 [PubMed – as supplied by publisher]

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Management of cutaneous squamous cell carcinoma in patients with epidermolysis bullosa – best clinical practice guidelines.
Br J Dermatol. 2015 Aug 24;
Authors: Mellerio JE, Robertson SJ, Bernardis C,… Continue reading →