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ABSTRACT: Tumour necrosis factor antagonists (anti-TNF-α) have demonstrated the efficacy in different chronic immune inflammatory disorders. Within the spectrum of adverse events, autoimmune diseases have been observed, including cases of alopecia areata (AA).
The objective of the study is to characterize AA developed during anti-TNF-α therapy.
We present five new cases and review all the cases reported in the literature (eleven).
One third of the cases had a positive (personal or family) history of AA. Most of them presented with rapid extensive AA, usually involving the ophiasis area. Prognosis was usually poor, with slight response to treatments. In the cases where anti-TNF-α therapy was maintained, the course did not seem to change.
Although rare, AA developed during anti-TNF-α therapy might be more frequent than suggested by reports of isolated cases. Personal and family history of autoimmune disease might alert clinicians to their possible development or relapse once the anti-TNF-α therapy is started.
Journal of the European Academy of Dermatology and Venereology 04/2011; 25(4):479-84. · 2.98 Impact Factor
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Clinical and Experimental Dermatology 06/2010; 35(4):453-4. · 1.20 Impact Factor
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ABSTRACT: Psoriasis is an immune-mediated disease typically associated with cutaneous neutrophilic infiltration and Munro microabscesses. Interleukin (IL)-8 is one of the main neutrophil-attracting chemokines. Although keratinocytes have traditionally been considered to be the principal source of IL-8 in psoriasis, we present data that suggest that cutaneous lymphocyte associated antigen (CLA) + T lymphocytes synthesize this cytokine.
Six patients with psoriasis and 6 healthy controls were studied. Immunomagnetic separation was used to isolate CLA+ and CLA- T lymphocytes and IL-8 and interferon (IFN)-gamma production was quantified for each cell subpopulation using enzyme-linked immunosorbent assay. Finally, gene expression of IL-8 was analyzed by reverse transcriptase-polymerase chain reaction.
CLA+ and CLA- T lymphocytes from patients with psoriasis and from controls showed a significantly increased production of IFN-gamma when activated, whereas only activated CLA+ T lymphocytes (from patients and controls) synthesized IL-8. The higher level of expression of IL-8 and IFN-gamma by CLA+T lymphocytes in comparison to CLA- cells was confirmed.
Previous studies have confirmed IL-8 production by T lymphocytes in inflammatory skin diseases with neutrophil-rich infiltrates, such as acute generalized exanthematous pustulosis, Behçet disease, and pustular psoriasis. We have confirmed the role of the subset of T lymphocytes with skin tropism (CLA+) in IL-8 production in nonpustular psoriasis.
Actas Dermo-Sifiliográficas 03/2010; 101(2):151-5.
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ABSTRACT: Palmoplantar punctate keratoses may be the main cutaneous sign of various diseases (porokeratosis punctata palmaris et plantaris, keratosis punctata of the palmar creases, familial punctate palmoplantar keratoderma) or represent a secondary feature [Cowden's syndrome (CS) and Darier's disease]. In CS, such keratoses usually appear during the second and third decades of life, together with other mucocutaneous features. We present the case of a 3-year-old girl with palmoplantar punctate keratoses in whom diagnosis of new-onset CS was suspected only after the development of other cutaneous lesions. Genetic analysis confirmed the diagnosis. This case highlights the necessity to consider CS in the differential diagnosis when palmoplantar punctate keratoses are found, even in paediatric patients. A prompt diagnosis is important in order to monitor the development of possible underlying associated neoplasms.
Clinical and Experimental Dermatology 08/2009; 34(5):e28-30. · 1.20 Impact Factor
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ABSTRACT: Cutaneous lymphocyte antigen (CLA) is expressed by a subgroup of memory T cells that exhibit skin homing and are implicated in cutaneous T-cell-mediated diseases.
Expression of genes associated with psoriasis was analyzed in keratinocytes taken from patients and healthy individuals and cultured under different conditions, including activation using supernatants from CLA(+) T lymphocytes activated with anti-CD3 and anti-CD28 antibodies.
Keratinocytes from psoriasis patients activated by CLA(+)T lymphocytes expressed higher levels of interferon-inducible protein 10, HLA-DR, intercellular cell adhesion molecule 1, and inducible nitric oxide synthase.
Our results suggest that we have developed an in vitro model that will allow analysis of the effector role of CLA(+) T lymphocytes on keratinocytes in psoriasis. This model may allow the identification of genes involved in the pathology of psoriasis through induction by CLA(+) T lymphocytes.
Actas Dermo-Sifiliográficas 12/2008; 99(9):701-7.
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Clinical and Experimental Dermatology 08/2008; 33(4):509-11. · 1.20 Impact Factor
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M Ferran,
F Gallardo,
A M Ferrer,
A Salar,
E Pérez-Vila,
N Juanpere,
R Salgado,
B Espinet,
A Orfao,
L Florensa,
R M Pujol
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ABSTRACT: Myeloid or type 1 dendritic cell leukaemia is an exceedingly rare haematopoietic neoplasm characterized by a specific immunophenotypic profile close to plasmacytoid dendritic cell and acute myelogenous leukaemia. A 77-year-old man presenting specific cutaneous infiltration by myeloid dendritic cell leukaemia is reported. The clinical features as well as the cutaneous histopathological and immunohistochemical features led to the initial diagnosis of CD4+/CD56+ haematodermic neoplasm. However, extensive immunophenotypic studies performed from peripheral blood blasts disclosed that leukaemic cells expressed myeloid dendritic cell markers, confirming the diagnosis. The diagnostic difficulties of specific cutaneous involvement by myeloid dendritic cell leukaemia on the basis of routine histopathological and immunohistochemical features are highlighted.
British Journal of Dermatology 06/2008; 158(5):1129-33. · 3.67 Impact Factor
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ABSTRACT: The safety data for adalimumab in psoriasis are similar to those described for other indications authorized for this drug. Most of the adverse effects observed (mainly, reaction at the injection point and upper respiratory tract infections) are of mild intensity and do not make it necessary to discontinue the drug. Serious adverse effects have been described in a low proportion of patients and include infections (tuberculosis and other opportunistic infections), lymphoproliferative conditions, autoimmune diseases and demyelinizing processes. Similar to other anti-tumor necrosis factor alpha (anti-TNFalpha) treatments, the experience with adalimumab only provides information regarding its middle term safety. Thus, some years are needed to verify these results in the longer term. Due to this, the patients who are candidates for the drug must be correctly screened and they must be closely monitored during the treatment period and until 5 months after it.
Actas Dermo-Sifiliográficas 03/2008; 99 Suppl 3:15-24.
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British Journal of Dermatology 02/2008; 158(1):174-6. · 3.67 Impact Factor
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ABSTRACT: Mycobacterium ulcerans infection causes a skin disease known as Buruli ulcer (BU), a disorder manifested usually as a solitary and painless nodule or papule that progresses to massive necrotizing destruction and cutaneous ulceration. When healing occurs, it often results in disabling deformities. Buruli ulcer is considered the third most common mycobacterial disease in immunocompetent people, after tuberculosis and leprosy. Although the emergence of Buruli ulcer in Western African countries over the past decade has been dramatic, it has been scarcely reported in industrialized countries. We report a patient from Equatorial Guinea who was human immunodeficiency virus-positive, presenting aggressive and multifocal BU associated with an underlying destructive osteomyelitis, in which only an aggressive surgical approach yielded to a resolution of the disease. In a global world, with increasing migratory population fluxes, an increased awareness of dermatologists regarding the clinical, histopathological and microbiological features of BU is important in order to avoid significant delays in diagnosis and treatment.
Clinical and Experimental Dermatology 12/2005; 30(6):649-51. · 1.20 Impact Factor
