Inflamed actinic keratoses as a biomarker in repositioning of chemotherapeutics: a systematic review and meta-analysis.

BACKGROUND: Inflammation of actinic keratoses (AK) was originally described with systemic 5-fluorouracil, and led to the development of topical fluorouracil. Similar observations using different chemotherapeutics may point to other drugs with a potential for repositioning. OBJECTIVE: This systematic review aims to evaluate chemotherapeutic agents linked to inflammation-induced cure of AK. METHODS: This systematic review was registered in PROSPERO (CRD42022346168) and followed PRISMA guidelines. A comprehensive literature search for eligible original articles written in English and published in peer-reviewed journals until July 13, 2022 was conducted in MEDLINE and Embase. RESULTS: 28 articles met inclusion criteria accounting for 36 patients (mean age 68.4 ± 8.3 years) with inflamed AK, exposed to 21 different chemotherapeutic agents - 21/36 (58.3%) received monotherapy and 15/36 (41.7%) received multidrug combinations. Regression was complete in 13/28 (46.4%) and partial in 14/28 (50.0%) of inflamed AK. Cure rates of inflamed AK in multidrug combinations were not superior to monotherapies (p = .252), leading to the observation that the majority of the former (14/15; 93.3%) encompassed one of five chemotherapeutic agents linked to AK inflammation also as a monotherapy. CONCLUSION: Overall, inflammation partially/completely cured AK in 96.4% of patients (27/28). Taxanes, pemetrexed, and doxorubicin might have the potential for the management of AK.

Skin and gut microbiota dysbiosis in autoimmune and inflammatory skin diseases.

The human body is inhabited by complex communities of microorganisms. Changes in the composition and function of the skin and gut microbiota are linked to various skin diseases. The microbiota is an important modulator of the immune system and thus maintains homeostasis. Conversely, the immune system can also change the composition of the microorganism community. Thus, it is still unknown whether certain skin diseases are caused by primary changes in the local and/or remote microbiota, or whether dysbiosis is only a secondary consequence of the dermatoses themselves. Expanding knowledge of skin and gut microbiota dysbiosis in skin diseases may possibly lead to better understanding of their pathophysiologies and to the discovery of new molecular markers for their earlier diagnosis and targeted treatment; for example, using specific microbes to replace missing ones. This narrative review provides an overview of current knowledge about skin and gut microbiota dysbiosis in psoriasis, atopic dermatitis, hidradenitis suppurativa, seborrheic dermatitis, acne vulgaris, rosacea, and lichen sclerosus.

Palisaded neutrophilic granulomatous dermatitis in a patient with HLA-B27-negative axial spondyloarthritis: a case report and literature review.

Palisaded neutrophilic granulomatous dermatitis (PNGD) is a rare histopathological pattern belonging to a group of cutaneous granulomatous eruptions that typically manifests with asymptomatic skin-colored, erythematous, or violaceous papules or nodules. PNGD can be triggered by various systemic conditions, including medications and autoimmune and autoinflammatory disorders, as well as malignancies; for example, lymphoproliferative disorders. Therefore, in patients with PNGD an extended diagnostic workup is mandatory as well as follow-up in the case of idiopathic PNGD. To the best of our knowledge, this is the first reported case in the literature of PNGD causally related to a relapse of HLA-B27-negative axial spondyloarthritis.

Cutaneous adverse effects of biologic drugs in psoriasis: a literature review.

Psoriasis is a chronic immune-mediated skin disease that affects 125 million people worldwide. Over the last two decades, biologic drugs have revolutionized the treatment of moderate to severe plaque psoriasis. They act on one or more molecular targets and thus modify or inhibit signal transduction pathways in the pathophysiological process of the disease. This articles summarizes cutaneous adverse effects to biologic drugs used in the treatment of psoriasis. Because they were on the market first, most of the literature covers cutaneous adverse effects of tumor necrosis factor-α (TNF-α) inhibitors, but increasingly more data are also available for adverse effects caused by newer biologics that inhibit the interleukin (IL)-12/23, IL-17, and IL-23 pathways. Some cutaneous adverse effects are general-for example, injection site reactions-whereas others are more class-specific; namely, Candida infections in IL-17 inhibitors. However, because some biologic drugs used in psoriatic patients are also registered for the treatment of certain other immune-mediated diseases such as rheumatoid arthritis, data regarding cutaneous adverse effects come from various sources that differ in quality and often cannot be interpreted without bias.