Risk factors for scabies treatment resistance: a retrospective cohort study.

BACKGROUND: In order to successfully treat scabies and to prevent its spread, it is important to identify the factors that can influence the outcome of scabies treatment. OBJECTIVES: This study was designed to evaluate the risk factors associated with treatment resistance scabies during use of an effective topical medication. METHODS: A retrospective cohort study was performed in patients with scabies infestations confirmed by potassium hydroxide (KOH) examinations. Patient characteristics, clinical features and treatment history were collected. The treatment resistance group included patients with persistent scabies infestations for more than 28 days after initiation of antiscabies treatment with 5% permethrin cream. RESULTS: In total, 138 patients with scabies infestations treated between January 2017 and December 2020 were included in this study. Of these, 100 (72.5%) patients were treated successfully, while 38 (27.5%) patients experienced treatment resistance. In the univariable analysis, risk factors for treatment resistance scabies included impaired cognitive function (OR = 2.66, 95% CI, 1.15-6.14), limited mobility (OR = 2.97, 95% CI, 1.30-6.83), inpatient status (vs. outpatient, OR = 3.3, 95% CI, 1.28-8.54), topical steroid use before diagnosis (OR = 3.52, 95% CI, 1.61-7.81), systemic steroid use before diagnosis (OR = 3.57, 95% CI, 1.26-10.34) and a positive KOH exam after the first treatment (OR = 7.25, 95% CI, 3.24-17.11). In the multivariable analysis, limited mobility (OR = 3.46, 95% CI, 1.02-12.11) and topical steroid use before diagnosis (OR = 3.65, 95% CI, 1.41-9.75) were significant predictive factors for treatment resistance scabies. CONCLUSIONS: Scabies patients with limited mobility and topical steroid use before diagnosis are at high risk of treatment resistance. Dermatologists should take these findings into consideration when treating patients with scabies infestations.

Onychomycosis in a premature infant caused by Candida tropicalis.

We report a case of onychomycosis caused by Candida tropicalis in a 107-day-old infant.

Cloning and characterization of GITR ligand.

The gene encoding the natural ligand of murine glucocorticoid-induced tumor necrosis factor receptor (GITR) was cloned and characterized. The putative GITR ligand (GITRL) is composed of 173 amino acids with features resembling those of type II membrane proteins and is 51% identical to the human activation-inducible TNF receptor (AITR) ligand, TL6. Expression of the GITRL is restricted to immature and mature splenic dendritic cells. GITRL binds GITR expressed on HEK 293 cells and triggers NF-kappaB activation. Functional studies reveal that soluble CD8-GITRL prevents CD4+CD25+ regulatory T-cell-mediated suppressive activities.

Molecular cloning of agonistic and antagonistic monoclonal antibodies against human 4-1BB.

Previously, we prepared two different monoclonal antibodies (mAbs) against human 4-1BB (CD137): an agonistic mAb BBK-1 and an antagonistic mAb BBK-2. In this paper, we describe the molecular cloning of these two mAbs and present comparisons of their amino acid sequences. cDNAs encoding the heavy (H) and light (L) chains of the two mAbs were cloned by screening of cDNA libraries constructed from hybridomas secreting these mAbs. Comparisons of amino acid sequences of the two mAbs showed that, while the constant regions of the H and L chains were identical between the two mAbs, the variable region showed 45% identity in H chains and 48% identity in L chains. This suggests that these two mAbs recognize different epitopes of 4-1BB and may have different effects on the activity of 4-1BB.