Subject(s)
Dermatology/organization & administration , Referral and Consultation , Telemedicine/organization & administration , Waiting Lists , Cost Savings , Dermatology/economics , Dermatology/standards , Efficiency , Humans , Medically Underserved Area , Nurses/statistics & numerical data , Patient Satisfaction , Referral and Consultation/standards , Referral and Consultation/statistics & numerical data , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/therapy , Skin Diseases/diagnosis , Skin Diseases/therapy , Surveys and Questionnaires , Sweden , Telemedicine/economics , Telemedicine/standards , Venereology/economics , Venereology/organization & administration , Venereology/standards , WorkforceABSTRACT
Identification of tissue-specific mechanisms involved in the pathophysiology of inflammatory skin diseases could offer new possibilities to develop effective therapies with fewer systemic effects. The serine protease stratum corneum chymotryptic enzyme is preferentially expressed in cornifying epithelia. We have previously reported on increased expression of the stratum corneum chymotryptic enzyme in psoriasis. Here is reported an increased epidermal expression of stratum corneum chymotryptic enzyme also found in chronic lesions of atopic dermatitis. Transgenic mice expressing human stratum corneum chymotryptic enzyme in suprabasal epidermal keratinocytes were found to develop pathologic skin changes with increased epidermal thickness, hyperkeratosis, dermal inflammation, and severe pruritus. The results suggest that stratum corneum chymotryptic enzyme may be involved in the pathogenesis of inflammatory skin diseases, and that stratum corneum chymotryptic enzyme and related enzymes should be evaluated as potential targets for new therapies.