Anthony A Gaspari

Anthony A Gaspari
University of Maryland, Baltimore | UMB · Department of Dermatology

MD

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263
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Publications

Publications (263)
Article
Full-text available
Background: Allergic contact dermatitis involving the hands is a common occupational skin disease for hairdressers and the potent sensitizers p-phenylenediamine (PPD) and toluene-2,5-diamine (PTD) are associated with the development of occupational allergic contact dermatitis. Objective: The aim of the study was to analyze whether the use of the...
Article
Background. Allergic contact dermatitis after exposure to p-phenylenediamine (PPD)-containing hair dye products is a common and important clinical problem. Because there is a high rate of cross-elicitation of allergic contact dermatitis to other important hair dye products (such as p-toluene diamine [PTD] and other aminophenol hair dyes) in PPD all...
Article
Occupational exposure of hairdressers to hair dyes has been associated with the development of allergic contact dermatitis (ACD) involving the hands. p-Phenylenediamine (PPD) and toluene-2,5-diamine (PTD) have been implicated as important occupational contact allergens. To conduct a quantitative risk assessment for the induction of contact sensitiz...
Chapter
Gynecological, neurovascular, oculoplastic devices and Nuss bars are a diverse group of medical implants with various metal compositions. Hypersensitivity reactions to these implants have been reported and range from either nonexistent or very rare to serious adverse reactions. The epidemiology of hypersensitivity reactions to some of these implant...
Chapter
Primary immunodeficiencies are estimated to affect about 255,000 people in the United States, with at least 120 distinct primary immunodeficiencies described in the literature. They can generally be classified according to which arm of the immune system the defect targets (i.e., innate versus adaptive, humoral versus cellular). All of the primary i...
Article
A 33-year-old woman presented with recurring pruritic, erythematous papules around the mouth and on the hands, of 1.5 years' duration. These flares typically began several days before her menstrual cycle and persisted for approximately 1 week. Physical examination revealed urticarial plaques on the neck. Due to the nature of the eruption, which cor...
Chapter
Cell death is a necessary part of the life of an organism. In order to grow and maintain health at an organismal level, tissues and cells must be able to withstand injury, die, or recover. The skin is perhaps the most dramatic example of this paradigm. Skin cells are constantly exposed to the external environment and the associated stressors. One o...
Chapter
There are two major arms of the immune system: the innate immune response and the adaptive immune response. Innate immunity is the first line of defense against microbes and serves to limit infection within the early hours after exposure to a pathogen. It is classically associated with the recognition of pathogens by phagocytic cells via specific r...
Book
This book is an in-depth and user-friendly reference for better understanding immune-mediated skin diseases and their therapies. The focus is on the needs of the physician, resident, or student to understand the pathophysiology of the disease as well as the mechanisms of action of the therapies. Clinical and Basic Immunodermatology, Second Edition...
Article
Background: Allergic contact dermatitis after exposure to p-phenylenediamine (PPD)-containing hair dye products is a common and important clinical problem. Because there is a high rate of cross-elicitation of allergic contact dermatitis to other important hair dye products (such as p-toluene diamine and other aminophenol hair dyes) in PPD-allergic...
Article
UVR-induced apoptosis in cutaneous antigen presenting cells (APC) causes systemic immune suppression and is dependent on TLR4/MyD88 signaling, but the apoptotic signaling pathways have not been defined. Macrophages pre-treated with lipopolysaccharide (LPS) were unresponsive to subsequent LPS treatment; however, but were susceptible to UVR-induced a...
Article
The nickel is causes of allergic contact dermatitis (ACD) and of “systemic nickel allergy syndrome” (SNAS). From 2009 to 2015 a very large number of patients with allergies, presented to our Department of Dermatology and Allergology at Sant'Andrea Hospital in Rome; 700 of these showed an allergic reaction to nickel with a double clinical manifestat...
Article
Hypersensitivity to progesterone is a rare condition, and it represents a hypersensitivity reaction to endogenous progesterone. Here we report a case of a woman who presented to our attention for evaluation of a rash for a few years on her posterior elbows, forearms, and right lateral lower extremity. We report this case because it describes a rare...
Article
Contact hypersensitivity (CHS) is a simple in vivo assay of cell-mediated immune function in which exposure of epidermal and dermal cells to exogenous haptens results in a delayed-type hypersensitivity (DTH) reaction that can be measured and quantified. Epidermal Langerhans cells and dermal dendritic cells are the critical antigen-presenting cells...
Article
Introduction: The increasing use of metal implantable devices has raised awareness of nickel allergy. Preoperative patch testing for patients with pectus excavatum (PE) with a known metal allergy or history of atopy is an accepted practice before the Nuss procedure. The Nuss bar manufacturer offers a metal disc for preoperative testing for metal s...
Article
Epidermodysplasia verruciformis (EV) is a rare disorder characterized by disseminated cutaneous warts in predisposed patients who are highly susceptible to genus ß-papillomavirus infections. We present the case of a 40-year-old lymphocytopenic woman with a balanced chromosomal translocation and a 25-year history of refractory EV that was successful...
Article
Full-text available
The development of effective and well-tolerated biologic therapies has advanced the management of psoriasis by enabling clinicians to treat underlying disease mechanisms. Biologics approved for the treatment of moderate-to-severe psoriasis include three tumor necrosis factor alpha inhibitors and an interleukin-12/interleukin-23 inhibitor. The estab...
Article
Pyoderma gangrenosum (PG) and hidradenitis suppurativa (HS) are rare chronic inflammatory dermatoses of unknown etiologies that often are refractory to conventional treatments. The therapeutic benefits of tumor necrosis factor a (TNF-α) inhibitors have been reported in patients with refractory PG or HS. The copresentation of these 2 diseases has pr...
Article
Depleted uranium (DU)-containing weapons have been used in military operations since 1991. There is interest in following veterans who were occupationally exposed to DU by either inhalation or retention of fragments. A cohort of DU-exposed Gulf War I veterans has been followed longitudinally at the Baltimore Veterans Administration Medical Center s...
Article
UV radiation (UVR) induces DNA damage, leading to the accumulation of mutations in epidermal keratinocytes and immunosuppression, which contribute to the development of nonmelanoma skin cancer. We reported previously that the TLR4-MyD88 signaling axis is necessary for UV-induced apoptosis. In the dinitrofluorobenzene contact hypersensitivity model,...
Article
For those with severe alopecia areata, with greater than 50% scalp involvement, topical immunotherapy with diphenylcyclopropenone or squaric acid dibutylester is considered the treatment of choice. This article not only reviews the safety and efficacy of topical sensitizers for the treatment of alopecia areata but also highlights strides that have...
Article
Background UV-exposures result in accumulation of genetic lesions that facilitate the development of skin cancer. Numerous pharmacologic agents are currently under development to both inhibit formation of DNA lesions and enhance repair. Drugs must be evaluated in vitro, currently performed in cell culture systems, before being tested on humans. Cur...
Article
Bullous pemphigoid (BP) is a blistering autoimmune disease that primarily affects elderly patients who commonly present with comorbidities. Side effects from long-term treatment with conventional cytotoxic and immunosuppressive agents may increase morbidity and mortality in this patient population. We present a case of BP in a 78-year-old woman wit...
Article
Manganese chloride (MnCl2) 2.5% is included in the extended metals patch test series to evaluate patients for contact hypersensitivity to this metal salt. The objective of this study was to prospectively determine the rate of allergic and irritant patch test reactions to MnCl2 (Mn(II)), Mn2O3 (Mn(III)), and KMnO4 (Mn(VII)) in a cohort of patients u...
Article
Full-text available
Primary localized cutaneous nodular amyloidosis (PLCNA) is a rare disorder that manifests as the cutaneous formation of nodules composed of light-chain amyloid. Although the type of amyloid deposit is similar to primary systemic amyloidosis, there seems to be little, if any, crossover between the 2 diseases. Because reports of PLCNA are sparse, the...
Article
Full-text available
The cytokine IL-9, derived primarily from T-helper (Th)-9 lymphocytes, promotes expansion of the Th2 subset and is implicated in the mechanisms of allergic asthma. We hypothesize that IL-9 also plays a role in human allergic contact dermatitis (ACD). To investigate this hypothesis, skin biopsy specimens of positive patch test sites from non-atopic...
Article
UV irradiation-induced cellular damage is classically associated with apoptosis and is known to result in systemic immunosuppression. How the decision to undergo apoptosis is made following UV is not fully understood. We hypothesize that a central mediator of TLR signaling, MyD88, determines cell fate after UV exposure. Survival after UV of immorta...
Chapter
The traditional means of diagnosis of inflammatory skin diseases include physical examination, diagnostic tests such as skin biopsy for histology and immunofluorescence, and a variety of special serologic assays. Tools and techniques utilizing nanotechnology are designed to utilize less material; be minimally invasive; and offer rapid, sensitive, a...
Chapter
The skin is the largest organ in the body. It serves many functions, including thermoregulation, endocrine homeostasis, and transduction of environmental stimuli. The latter can be from simple registering of heat and cold to photoreception [1] or to the complex haptic processing required to read Braille. The skin actively and passively defends agai...
Chapter
Human skin is the largest organ of the body providing a protective coat to ensure that exogenous ‘noxious’ agents do not jeopardise the function of vital internal organ systems. Being situated at the interface between external and internal milieus, a number of remarkable structural and functional characteristics of skin have been delineated that co...
Article
During the 1991 GulfWar, U.S. service members were exposed to depleted uranium (DU) through friendly-fire incidents involving DU munitions and vehicles protected by DU armor. Routes of exposure to DU involved inhalation of soluble and insoluble DU oxide particles, wound contamination, and retained embedded DU metal fragments that continue to oxidiz...
Article
We report a case of Merkel cell polyomavirus detection in the skin of a patient with epidermodysplasia verruciformis (EDV) and a family history remarkable for an unusual inheritance pattern for EDV.
Article
Prurigo nodularis is a chronic, relapsing neurodermatitis that is often resistant to standard therapies with topical corticosteroids and oral antihistamines. Thalidomide, while efficacious in treating recalcitrant cases of prurigo nodularis, causes significant toxicity. Thalidomide-induced peripheral neuropathy frequently results in drug discontinu...
Chapter
A number of factors can lead to exaggerated immunity or autoimmunity. Traditional strategies for suppressing immunity include drugs and devices to suppress the immune system. Drug inhibitors of B cells and T cells include corticosteroids and antimetabolites. Devices for the inhibition of immunity include ultraviolet light and photopheresis apparati...
Article
Dopamine is a neurotransmitter which plays an important role in many human organs including the skin. In this study we will examine the presence and the distribution of D1 and D2 dopamine receptors in a particular zone of the human skin. Samples of the human plantar skin were harvested during autopsies after the consent of relatives of the dead don...
Article
Conventional CD8+ T-lymphocytes are thought to be major effector cells in allergic contact dermatitis (ACD). However, previous work has demonstrated a significant population of invariant natural killer T-cells (iNKT-cells) in the elicitation phase of ACD. In this study, we investigate whether iNKT-cells have the capacity to serve as effector lympho...
Article
Full-text available
Introduction Sarcoidosis is a systemic granulomatous disease of unknown cause. The management of sarcoidosis remains problematic. Systemic and topical corticosteroids are the mainstay of therapy but may cause unacceptable side effects. Biologic therapies, such as infliximab, have recently been proposed as another treatment option for cutaneous sarc...
Article
Toll-like receptor (TLR) signaling is a well-characterized, innate immune cellular defense mechanism used to detect and respond to pathogen-associated molecular patterns (PAMPs). TLR signaling is highly conserved and has evolved to have both extracellular and endosomal receptors that recognize PAMPs from a wide range of microbial pathogens. Recent...
Article
Manipulation of the immune system for clinical dermatology can be divided into three categories: augmentation of immunity, suppression of immunity, or alteration of immunity such as induction of tolerance. Current methods for augmenting immunity include vaccination, medications, or interventions such as stem cell transplantation. Traditional vaccin...
Article
Full-text available
Contact allergies are complex diseases, and one of the important challenges for public health and immunology. The German 'Federal Institute for Risk Assessment' hosted an 'International Workshop on Contact Dermatitis'. The scope of the workshop was to discuss new discoveries and developments in the field of contact dermatitis. This included the epi...
Article
Full-text available
Trichodysplasia spinulosa (TS) is a rare, disfiguring skin condition that affects immunosuppressed patients, universally involving the central face. New data point to the recently discovered TS-associated polyomavirus (TSPyV) as the causative agent. We report a case of TS in a 48-year-old African American man after renal transplant; via polymerase...
Article
Full-text available
The skin is a barrier site that is exposed to a wide variety of potential pathogens. As in other organs, pathogens that invade the skin are recognized by pattern-recognition receptors (PRRs). Recently, it has been recognized that PRRs are also engaged by chemical contact allergens and, in susceptible individuals, this elicits an inappropriate immun...
Chapter
Frequentemente si osservano manifestazioni dermatologiche nei pazienti affetti da malattie a carico del piccolo intestino, in particolare le malattie infiammatorie intestinali e soprattutto la malattia celiaca. Queste dermopatie sembrano essere correlate sia alla perdita della funzione assorbitiva e della motilità intestinale, che ai cambiamenti im...
Article
The art of tattooing has increasing in recent decades. Allergic sensitivity to one of the pigments is the most frequent cause of dermatological reactions at the site of the tattoo. Gold is a new pigment used in tattooing, because of its bright yellow color and luster. Allergy to this metal is uncommon. To our knowledge, this is the first reported c...
Article
We previously reported the case of a 33-year-old woman who was diagnosed as having livedoid vasculopathy (LV) associated with plasminogen activator inhibitor-1 (PAI-1) promoter homozygosity (4G/4G).1 In patients with homozygosity for the 4G allele, high levels of PAI-1 may be associated with increased risk of venous thromboembolism, coronary diseas...
Article
Nickel allergy can result in both cutaneous and systemic manifestations, and can range from mild to severe symptoms. A severe form of this allergy is the Systemic nickel allergy syndrome, clinically characterized by cutaneous manifestions (contact dermatitis, pompholyx, hand dermatitis dyshydrosis, urticaria) with chronic course and systemic sympto...
Article
Full-text available
Imiquimod is a TLR7/8 agonist that has anticancer therapeutic efficacy in the treatment of precancerous skin lesions and certain nonmelanoma skin cancers. To test our hypothesis that imiquimod enhances DNA repair as a mechanism for its anticancer activity, the nucleotide excision repair genes were studied in bone marrow-derived cells. Imiquimod enh...
Article
Tumor necrosis factor-a (TNF-a) inhibitors, such as adalimumab, are often used to treat psoriasis and psoriatic arthritis. While it is well known that these agents increase the risk of reactivation tuberculosis, recent evidence suggests that the risk of other nontuberculous mycobacterial (NTM) infections is on the rise. We report cutaneous Mycobact...
Article
Generalized verrucosis has been described in the past as synonymous with epidermodysplasia verruciformis. It has been shown, however, that epidermodysplasia verruciformis and other genetic or immunodeficiency diseases are just a subset of diffuse infections with human papillomavirus termed "generalized verrucosis." This article defines generalized...
Article
Full-text available
As part of a longitudinal surveillance program, 35 members of a larger dynamic cohort of 79 Gulf War I veterans exposed to depleted uranium (DU) during combat underwent clinical evaluation at the Baltimore Veterans Administration Medical Center. Health outcomes and biomonitoring results were obtained to assess effects of DU exposure and determine t...
Article
Multiple treatment modalities have been developed for the treatment of actinic keratoses (AKs). No systematic review has been undertaken to compare the cosmetic outcomes of these various modalities. We reviewed all available publications on PubMed on the treatment of AKs. We concluded that photodynamic therapy and imiquimod have the greatest amount...
Article
The Depleted Uranium Follow-Up Program is a clinical surveillance program run by the Baltimore Veterans Affairs Medical Center since 1993 for veterans of the Gulf and Iraqi wars who were exposed to depleted uranium (DU) as a result of "friendly-fire" incidents. In 2009, 40 veterans from this cohort were screened for skin reactivity to metals by pat...
Article
Topical antineoplastic agents have a well-established role in the treatment of several dermatological conditions. Their use in the treatment of mucosal skin disease also has gained increasing recognition. Topical 5-fluorouracil (5-FU), an antimetabolite, and imiquimod, an immunomodulatory agent with antitumor properties, are the two principal topic...
Article
Molluscum contagiosum virus (MCV) is a DNA virus in the Poxviridae family that may cause extensive and voluminous lesions often resistant to topical therapies in patients with AIDS and other immunocompromised patients. We present a case of eruptive giant molluscum that caused remarkable deformity in a patient with AIDS. Intravenous (IV) cidofovir w...
Article
Full-text available
Since the first reports of AIDS, skin involvement has become a burdensome stigma for seropositive patients and a challenging task for dermatologist and infectious disease specialists due to the severe and recalcitrant nature of the conditions. Dermatologic manifestations in AIDS patients act as markers of disease progression, a fact that enhances t...
Article
Full-text available
The European cosmetics legislation foresees a review in 2011 and possible postponement of the 2013 marketing ban to enforce the testing ban for systemic and repeated-dose animal tests. For this purpose, a 119-page report commissioned by the European Commission was published recently. Here, a group of 17 independent experts from the US, Europe, and...
Article
Leukocyte accumulation in the skin is associated with a wide range of skin disorders, including atopic dermatitis (AD), contact hypersensitivity, psoriasis and cutaneous T cell lymphomas. Natural killer (NK) and natural killer T (NKT) cells are lymphocytes that play a vital role in cell-mediated immunity. Although they belong to different lineages...
Article
Allergic contact dermatitis (ACD) is a common skin disease that has significant socio-economic impact. ACD is mediated by a T-cell mediated inflammatory reaction. Langerhans cells (LCs) are an epidermal DCs subset specialized in antigen presentation. After hapten exposure, LCs play a major role as in induction adaptive immune response against aller...
Article
Glatiramer acetate (GA) is indicated for use in patients with relapsing-remitting multiple sclerosis (RRMS). One of the side effects of GA is lipoatrophy, a localized loss of subcutaneous fat around the injection site. A Canadian postmarketing observational study on MS patients receiving GA was designed to provide further insight on lipoatrophy and...
Article
A 60-year-old African American man presented to the dermatology clinic for evaluation of skin and nail changes associated with docetaxel therapy for adenocarcinoma of the prostate. Previous treatment cycles ofdocetaxel had resulted in hyperpigmented patches and linear streaks on his arms where he received infusions, as well as nail changes, includi...
Article
Recently, a strong association between "psoriasis" and "atherosclerosis" has emerged. Psoriasis patients have an increased prevalence of atherosclerotic disease including coronary artery, cerebrovascular, and peripheral vascular diseases. The exact connection between psoriasis and atherosclerosis remains unclear, but it is thought that inflammation...
Article
Full-text available
Human papillomavirus (HPV) infections cause a spectrum of clinical disease states, depending on the causative HPV and the characteristics of the infected host, especially the status of cell-mediated immunity. Generalized verrucosis is an unusual clinical presentation of a disseminated HPV infection associated with severe immunodeficiency status. We...
Article
Full-text available
Biologic therapies are an efficacious new method of controlling a number of chronic conditions. Data regarding these medications continues to emerge, giving clinicians a greater understanding of their side effects profiles. The biologic agents used in dermatology, particularly the tumor necrosis factor-alpha inhibitors, have a number of varied derm...
Article
An 84-year-old male presented with recurrent nodular infiltrative basal cell carcinoma on the left shoulder. The patient was treated with curettage followed by the application of topical imiquimod 5% cream five times a week. The patient discontinued imiquimod after a total of 18 applications because of local inflammation. Depigmentation was noted i...