Risk factors associated with actinic prurigo: a case control study

Abstract: Background: Actinic prurigo (AP) is an idiopathic photodermatosis. Although its initial manifestations can appear in 6 to 8-year-old children, cases are diagnosed later, between the second and fourth decades of life, when the injuries are exacerbated. Objective: To identify risk factors associated with clinical manifestations of AP such as skin and mucosal lesions. Methods: Thirty patients with AP and 60 controls were included in the study, the dependent variable was the presence of skin or labial mucosal lesions, the independent variables were age, sex, solar exposure, living with pets or farm animals, exposure to wood smoke, smoking habit, years smoking, and hours spent per day and per week in contact with people who smoke. Results: Of the 30 diagnosed AP patients, 66.7% were female. Patients age ranged from 7 to 71 years and the mean age was 35.77 ± 14.55 years. We found significant differences with the age and cohabitation with farm animals. Those who lived with farm animals presented 14.31 times higher probability of developing AP (95% CI 3-78.06). Study limitations: This is a case-control study; therefore, a causal relationship cannot be proven, and these results cannot be generalized to every population. Conclusions: The identification of factors related to the development of AP increases our knowledge of its physiopathology. Moreover, identifying antigens that possibly trigger the allergic reaction will have preventive and therapeutic applications in populations at risk of AP.

Correlation of serum IgE levels and clinical manifestations in patients with actinic prurigo

Abstract BACKGROUND: Actinic prurigo is an idiopathic photodermatosis, the pathophysiology of which has been hypothesized to involve subtype IV type b (Th2) hypersensitive response, whereby IL4, IL5, and IL13 are secreted and mediate the production of B cells, IgE, and IgG4. OBJECTIVES: To examine the association of serum IgE levels and the clinical severity of injuries. METHODS: This case-control study comprised patients with a clinical and histopathological diagnosis of actinic prurigo, as well as clinically healthy subjects, from whom 3cc of peripheral blood was taken for immunoassay. Cases were classified by lesion severity as mild, moderate, and severe. Descriptive statistics were analyzed, and chi-square test was performed. RESULTS: We included 21 actinic prurigo patients and 21 subjects without disease; 11 patients with actinic prurigo had elevated serum IgE levels, and 10 had low serum levels. Six actinic prurigo (AP) patients with elevated serum levels of IgE had moderate injuries, 4 had severe injuries, and 1 had minor injuries. Eight out of 10 patients with normal IgE levels presented with minor injuries in the clinical evaluation. The 21 controls did not have increased serum IgE levels. CONCLUSIONS: Elevated IgE levels are associated with moderate to severe clinical lesions, suggesting that actinic prurigo entails a type IV subtype b hypersensitivity response in which Th2 cells predominate.

Enfermedades hereditarias de la dermis: revisión de la literatura / Hereditary diseases of the dermis: literature review

Nuestra piel tiene propiedades de elasticidad y firmeza, dada por las fibras del tejido conectivo ubicadas en la dermis. La elasticidad está dada principalmente por pequeñas fibraselásticas compuestas de elastina, mientras que la firmeza se explica por las redes de fibrillas de colágeno tipo I, III y V. La relevancia de estos componentes de la matriz extracelular, junto con otras fibras, como fibrilina y fibulina, se ha reflejado en el reconocimiento de diferentes enfermedades hereditarias causadas por mutaciones en estas proteínas. Muchas de éstas pueden tener características comunes, constituyendo un espectro de alteraciones, dependiendo de la proteína alterada, dando un pronóstico particular tanto en morbilidad y mortalidad. En esta revisión se desarrollarán las principales patologías de la dermis de importancia en dermatología.

Our skin is flexible and firm due to the fibers of the connective tissue in the dermis. Flexibility is mainly given by little elastic elastine fibers, meanwhile firmness is expressed by fibers networks made of collagen type I, III and V. The importance given to these components, including other fibers like fibrillin and fibulin in the extracellular matrix has been displayed in the recognition of different hereditary diseases caused by mutations in these proteins. Many of them have common characteristics, that build a wide spectrum of disorders depending on the altered protein, and give a particular prognostic in morbidity as well as in mortality. The main pathologies of the dermis with an importance in dermatology will be considered in this review.

Poiquilodermia acroqueratótica hereditaria (Weary): enfermedad inmunológica. Ubicación nosológica en una clasificación de las poiquilodermis ampollares hereditarias. Presentación de un caso con estudio inmunológico y ultraestructural / Acrokeratotic hereditary poikiloderma

Se realiza una revisión bibliográfica de casos de poiquilodermia Acroqueratótica Hereditaria o enfermedad de Weary (EW). Hemos concluido que dicha denominación pareciera ser usada en cuatro diferentes cuadros dermatológicos: 1) Enfermedad de Weary Acroqueratótica Hereditaria con herencia familiar autosómica dominante (EW-d); 2) Enfermedad de Weary, con herencia familiar autosómica recesiva y algunos rasgos clínicos de una EW-d asociada a manifestaciones de fotosensibilidad de un síndrome de Kindler; 3) Síndrome de Kindler-Weary (SK-W) con lesiones clínicas de un síndrome de Kindler (poliquilodermia con ampollas traumáticas y atrofia cutánea progresiva) e histopatológicas con manifestaciones liquenoides y presencia de "cuerpos citoides" de una EW-d y 4) Síndrome de Weary-Kindler con manifestaciones de una Poiquilodermia Esclerosante Hereditaria de Weary (HSP), asociada también a manifestaciones ampollares de un SK-r (WE-KS-r). Nosotros relatamos un nuevo caso clínico e histopatológico de una EW-d con presencia de "cuerpos citoides", como expresión de una reacción inmunológica mediada por células, demostrable por inmunohistoquímica. En el diagnóstico diferencial se destaca la distinta patogenia del SK que presenta una malformación displásica genética de la membrana basal electrónica (láminas lúcida y densa) y del tejido conectivo papilar dérmico con desaparición de las fibras elásticas. Nuestra revisión bibliográfica demostró que la EW-d y el SK-r representan dos "formas polares" patogénicas: una predominantemente inmunológica y la segunda malformativa displásica genética, en un amplio espectro de Poiquilodermias Ampollares Hereditarias (HAP), vinculadas con otras cuatro "formas subpolares": EW-r, SK-r, WE-KS-r y SK-d. Estas conclusiones están basadas en el análisis patogénico, clínico, histopatológico, inmunohistoquímico y ultraestructural de componentes del HAP