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1.
Clin Transl Allergy ; 13(9): e12299, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37746794

RESUMO

INTRODUCTION: The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. METHODS: The GA2 LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2 EN ADCARE centres. RESULTS: The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. CONCLUSION: The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD.

2.
Front Immunol ; 14: 1124018, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36993985

RESUMO

Background: The role of allergen sensitization in IL-31 production by T cells and specifically in the clinical context of atopic dermatitis (AD) has not been characterized. Methods: The response to house dust mite (HDM) in purified memory T cells cocultured with epidermal cells from AD patients (n=58) and control subjects (n=11) was evaluated. AD-associated cytokines from culture supernatants, plasma proteins and mRNA expression from cutaneous lesions were assessed and related with the clinical features of the patients. Results: HDM-induced IL-31 production by memory T cells defined two subsets of AD patients according to the presence or absence of IL-31 response. Patients in the IL-31 producing group showed a more inflammatory profile, and increased HDM-specific (sp) and total IgE levels compared to the IL-31 non-producing group. A correlation between IL-31 production and patient's pruritus intensity, plasma CCL27 and periostin was detected. When the same patients were analyzed based on sp IgE and total IgE levels, an increased IL-31 in vitro response, as well as type 2 markers in plasma and cutaneous lesions, was found in patients with sp IgE levels > 100 kUA/L and total IgE levels > 1000 kU/L. The IL-31 response by memory T cells was restricted to the cutaneous lymphocyte-associated antigen (CLA)+ T-cell subset. Conclusion: IgE sensitization to HDM allows stratifying IL-31 production by memory T cells in AD patients and relating it to particular clinical phenotypes of the disease.


Assuntos
Dermatite Atópica , Animais , Alérgenos , Células T de Memória , Citocinas , Pyroglyphidae , Imunoglobulina E
5.
JAAD Case Rep ; 4(7): 622-624, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30094300
6.
Pediatr Dermatol ; 35(5): e291-e293, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29974513

RESUMO

Inflammatory linear verrucous epidermal nevus and linear psoriasis are different entities with clinical and histopathologic similarities. Isolated reports of inflammatory linear verrucous epidermal nevus with concomitant psoriasis or a positive family history of psoriasis have been described, and the possibility that inflammatory linear verrucous epidermal nevus may be a mosaic form of cutaneous psoriasis has been postulated. We report a 17-year-old boy with a congenital, linear, erythematous, keratotic plaque on the dorsum of the fifth finger of the left hand with ipsilateral nail dystrophy. Histopathologic examination showed epidermal hyperplasia with alternating orthokeratosis and parakeratosis. During follow-up, he developed erosive monoarthritis of the distal interphalangeal joint. This case seems to confirm the association between inflammatory linear verrucous epidermal nevus and arthritis and supports a possible relationship between inflammatory linear verrucous epidermal nevus and psoriasis.


Assuntos
Artrite/complicações , Nevo Sebáceo de Jadassohn/diagnóstico , Adolescente , Artrite/tratamento farmacológico , Diagnóstico Diferencial , Glucocorticoides/uso terapêutico , Humanos , Masculino , Nevo Sebáceo de Jadassohn/complicações , Nevo Sebáceo de Jadassohn/tratamento farmacológico , Pele/patologia
8.
Acta Derm Venereol ; 97(6): 698-704, 2017 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-28303277

RESUMO

Although the efficacy of omalizumab has been clearly demonstrated in the treatment of chronic spontaneous urticaria (CSU), its mechanism of action, which results in improvement in CSU symptoms, is not entirely understood. This study investigated the effect of omalizumab on expression of the high-affinity IgE receptor (FcεRI) on blood basophils from patients with active CSU, and its association with the clinical response. Patients exhibiting significant clinical improvement showed a sharp reduction in the levels of basophil FcεRI after 4 weeks, which was maintained throughout the total duration of the treatment. Such evolution was not observed in non-responder patients. Furthermore, non-responders showed significantly lower baseline levels of FcεRI than responders. Baseline basophil FcεRI expression was found to be a potential immunological predictor of response to omalizumab (100% sensitivity and 73.2% specificity). The results of this study contribute to our knowledge of the therapeutic benefit and mechanism of action of anti-IgE therapy in CSU.


Assuntos
Antialérgicos/uso terapêutico , Basófilos/imunologia , Omalizumab/uso terapêutico , Receptores de IgE/sangue , Urticária/tratamento farmacológico , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Urticária/sangue , Urticária/diagnóstico , Urticária/imunologia
9.
Int J STD AIDS ; 28(7): 732-734, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27881812

RESUMO

The typical finding in secondary syphilis stage is a generalized non-pruritic maculopapular eruption. We report a case of secondary syphilis in an HIV-infected patient presenting with pruritic crusted nodules showing numerous eosinophils on the histopathological examination.


Assuntos
Antibacterianos/uso terapêutico , Penicilina G Benzatina/administração & dosagem , Sífilis Cutânea/patologia , Sífilis/tratamento farmacológico , Treponema pallidum/isolamento & purificação , Exantema , Infecções por HIV/tratamento farmacológico , Humanos , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Penicilina G Benzatina/uso terapêutico , Sífilis/patologia , Sífilis Cutânea/tratamento farmacológico , Resultado do Tratamento , Treponema pallidum/imunologia
10.
J Am Acad Dermatol ; 75(5): 918-924.e2, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27485164

RESUMO

BACKGROUND: Data about special phenotypes, natural course, and prognostic variables of patients with acquired cold urticaria (ACU) are scarce. OBJECTIVES: We sought to describe the clinical features and disease course of patients with ACU, with special attention paid to particular phenotypes, and to examine possible parameters that could predict the evolution of the disease. METHODS: This study was a retrospective chart review of 74 patients with ACU who visited a tertiary referral center of urticaria between 2005 and 2015. RESULTS: Fourteen patients (18.9%) presented with life-threatening reactions after cold exposure, and 21 (28.4%) showed negative results after cold stimulation tests (classified as atypical ACU). Nineteen patients (25.7%) achieved complete symptoms resolution at the end of the surveillance period and had no subsequent recurrences. Higher rates of atypical ACU along with a lower likelihood of achieving complete symptom resolution was observed in patients who had an onset of symptoms during childhood (P < .05). In patients with atypical ACU, shorter disease duration and lower doses of antihistamines required for achieving disease control were detected (P < .05). Age at disease onset, symptom severity, and cold urticaria threshold values were found to be related to disease evolution (P < .05). LIMITATIONS: This study was limited by its retrospective nature. CONCLUSIONS: The knowledge of the clinical predictors of the disease evolution along with the clinical features of ACU phenotypes would allow for the establishment of an early and proper therapeutic strategy.


Assuntos
Temperatura Baixa/efeitos adversos , Urticária/etiologia , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Angioedema/epidemiologia , Angioedema/etiologia , Criança , Pré-Escolar , Comorbidade , Progressão da Doença , Feminino , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Hipersensibilidade Imediata/epidemiologia , Lactente , Masculino , Fenótipo , Prognóstico , Estudos Retrospectivos , Centros de Atenção Terciária , Resultado do Tratamento , Urticária/diagnóstico , Urticária/tratamento farmacológico , Urticária/epidemiologia , Adulto Jovem
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