Abstracts for the British Association of Dermatologists 102nd Annual Meeting

The proceedings contain 388 papers. The topics discussed include: vitiligo diagnosis is associated with an increase in new-onset depression and anxiety: a population-based cohort study in the UK;effect modification of biologic survival by patient characteristics: a prospective cohort study from the British Association of Dermatologists Biologics And Immunomodulators Register;'a raised P3NP is a matter of time': replacing P3NP with FIB-4 for monitoring of methotrexate-related liver fibrosis;a randomized controlled trial assessing the effectiveness and safety of ciclosporin vs. methotrexate in the treatment of severe atopic eczema in children and young people: the treatment of severe atopic eczema trial (TREAT);carbonylated proteins as markers of oxidative stress and their association with filaggrin genotype in atopic eczema;skin tumors in England 2013-2019: in-depth reporting of a new consensus classification to improve prospective data extraction and clinical interpretation;a national review of porocarcinoma epidemiology in England 2013-2018;national Merkel cell carcinoma epidemiology and mortality-related risk factors in England 2004-2018;and hospitalization from COVID-19 is most frequently observed in patients with atopic dermatitis treated with systemic corticosteroids, and in particular when systemic corticosteroids are used in combination with another immunomodulatory treatment: lessons from the global SECURE-AD registry.

Mutations in FLG, the gene-coding profilaggrin/filaggrin, are associated with putative hay fever in patients with atopic dermatitis

Filaggrin plays a key role in the barrier function of the skin. Mutations in the gene encoding profilaggrin/filaggrin, FLG, are a predisposing factor for atopic dermatitis (AD). Thymus and activation-regulated chemokine/ C-C motif chemokine ligand 17 (TARC/CCL17) along with immunoglobulin (Ig) E, are considered reliable serum markers of Th2-dominant inflammation. We performed analyses of association between FLG mutation status and the serum levels of IgE, TARC, and history in patients with AD. This study was approved by the Ethics Review Committee of Nagoya University Graduate School of Medicine, Aichi, Japan. Twenty-eight patients (14 males, 14 females;age range 3–45 y) with AD, who visited the out-patient clinic of dermatology, Hirosaki University Hospital, were included. Of the 28 AD patients, 5 were carriers of 1 of 10 FLG mutations. Thus, the incidence rate was 17.9%. FLG mutations were associated with putative hay fever (odds ratio = 10 [95% CI 1.15–86.89]), however, were not associated with asthma (odds ratio = 5.5 [95% CI 0.28–107.16]). As for the aggravated COVID-19 patient, it was confirmed that a serum TARC level showed a low value. Although there is not the statistical significant difference between IgE, TARC, and FLG mutations, we found an association between FLG mutation positivity and putative hay fever in AD patients. Our study is limited by the small sample size, nevertheless, the findings show a significant association between FLG mutations and hay fever and provide evidence for the role of FLG mutations in the pathogenesis of hay fever.

Validated method for assessing the effects of blue light on human skin

The COVID pandemic caused an increase in virtual meetings & work from home scenarios that resulted in people spending increased time in front of computer screens & electronic devices. Studies have shown that blue light can produce cytotoxic effects, primarily through the production of reactive oxygen species & increased inflammation. However, the topic has been controversial with some studies claiming no adverse effects of blue light on the skin. Methods for testing the effects of blue light using in vitro testing models are lacking. Our work was conducted in order to develop a reproducible, validated testing method for assessing the effects of blue light on the skin. We designed a custom blue-light box that can be used to generate blue light at 460 nm wavelength. We performed a series of studies to optimize the dose and timing of the exposure & skin-culture conditions. Our work demonstrates that 6 hours of daily blue light for 5 consecutive days (total 30 J/cm2) produced a dose-and-time dependent decrease in skin health in 3D full thickness in vitro skin tissues. In addition, gene expression data showed an increase in the expression of genes that regulate inflammation and oxidative stress pathways (IL1A, IL6, CXCL8, COX2, CYP1B1, & NQO1) & a decrease in the expression of genes that maintain skin barrier and integrity (KRT1, KRT10, LOR, DSC and Collagen). Genes regulating skin aging & hydration including MMP1 & FLG were also regulated by exposure to blue light. Enzyme-linked immunoassays were performed to confirm changes in specific proteins. Exposure to blue light significantly increased 8-hydroxy-2' -deoxyguanosine, a marker for oxidative stress, & MMP1, markers for photoaging. Immunohistochemistry staining was performed to confirm changes in Collagen, Filaggrin & NQO1 protein expression in skin tissue. Our results showed that consistent blue light exposure produced skin damage via alterations in key biological pathways. This work provides a new, reproducible in vitro testing method for assessing the effects of blue light on human skin using gene expression, protein ELISA and IHC staining.

Netherton syndrome plus atopic dermatitis: Two new genetic mutations in the same patient.

A child who comes to our attention for the appearance of erythematous, scaly lesions localized to the upper and lower limbs for 2 months. Histological features suggested ichthyosiform disease and concomitant mutations in the SPINK5 and FLG2 genes confirmed Netherton syndrome with severe atopic manifestations.