Recent developments in our understanding of autoinflammatory keratinization diseases
Stephen Chu-Sung Hu
Department of Dermatology, Kaohsiung Medical University Hospital; Department of Dermatology, College of Medicine, Kaohsiung Medical University; Department of Dermatology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
Correspondence Address:
Dr. Stephen Chu-Sung Hu
Department of Dermatology, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung 807
Taiwan
Source of Support: None, Conflict of Interest: None
DOI: 10.4103/1027-8117.365589
Autoinflammatory keratinization disease (AiKD) is an emerging disease concept and is a group of keratinizing skin conditions characterized by increased activation of the innate immune system.[1] These diseases include generalized pustular psoriasis,[2],[3] pityriasis rubra pilaris,[4] hidradenitis suppurativa,[5] and porokeratosis.[6] Recently, the underlying etiologies and molecular mechanisms associated with the development of AiKDs have been gradually elucidated. In this issue of Dermatologica Sinica, a comprehensive review by Akiyama described the clinical features and pathogenesis of various AiKDs.[7] In particular, recent advances in elucidation of underlying signaling pathways and novel treatment strategies were emphasized. It is expected that more skin disorders will be included as AiKDs in the near future, and our increasing understanding regarding their pathogenic mechanisms will lead to the development of new therapeutic modalities.
This issue of Dermatologica Sinica
Recently, with increasing emphasis on the application of evidence-based medicine in clinical practice, there has been a growing number of publications based on systemic reviews and meta-analyses. In order to improve the quality of systemic reviews, various international guidelines have been established in the research community.[8] In this issue, Kuo et al. described the essential steps involved in performing a high-quality systemic review.[9] Understanding these important steps will ensure the quality of systemic reviews and enable the provision of current best evidence for clinical decision-making.
Alopecia areata is a common autoimmune disease characterized by circular patches of hair loss on the scalp and other body regions. Huang and Tsai used a retrospective approach to investigate the therapeutic effect of diphenylcyclopropenone (a topical contact allergen) for alopecia areata in a Taiwanese medical center. They found that topical diphenylcyclopropenone is an effective form of treatment for alopecia areata, with >90% sustainable hair regrowth in 32.6% (28 out of 86) of patients.[10] However, possible side effects associated with this topical treatment modality should be monitored.
Extramammary Paget's disease is a malignant skin condition with high recurrence rate and poor prognosis.[11],[12] In this issue of Dermatologica Sinica, Hou et al. performed a retrospective study to investigate the clinical and pathological characteristics of perianal Paget's disease in a Taiwanese medical center.[13] They found that out of 8 patients with perianal Paget's disease, four cases were associated with underlying rectal or anal adenocarcinoma (secondary extramammary Paget's disease). In addition, they found differential expression of CK7 in the epidermal and dermal cancer cells for two cases with secondary perianal Paget's disease. These findings may have implications for the diagnosis of this skin malignancy.
Recently, COVID-19 vaccines have been administered to the worldwide population. However, there have been reports of cutaneous side effects following vaccination in a minority of people.[14],[15] These adverse effects include new onset or exacerbation of urticaria,[16] psoriasis,[17] atopic dermatitis,[18] and lupus erythematosus.[19] In this issue, Chao and Liu described a patient who developed bullous pemphigoid following AstraZeneca COVID-19 vaccination.[20] Therefore, dermatologists should be aware of the possibility of various immune-mediated cutaneous diseases which may occur following the administration of COVID-19 vaccines.
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Nil.
Conflicts of interest
There are no conflicts of interest.
References
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