EDITORIAL Year : 2023  |  Volume : 41  |  Issue : 2  |  Page : 65-66

Scoring systems for pemphigus

Chao-Kai Hsu
Department of Dermatology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University; International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan

Date of Submission01-Jun-2023Date of Acceptance02-Jun-2023Date of Web Publication29-Jun-2023

Correspondence Address:
Dr. Chao-Kai Hsu
Department of Dermatology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University; International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan
Taiwan

Source of Support: None, Conflict of Interest: None

DOI: 10.4103//DS.V41-1_Editorial

How to cite this article:
Hsu CK. Scoring systems for pemphigus. Dermatol Sin 2023;41:65-6
  Scoring Systems and Validation Studies for Pemphigus 

Pemphigus is a heterogeneous group of autoimmune vesiculobullous diseases characterized by autoantibodies against desmosomal adhesion molecules of the epidermis, affecting both the mucous membranes and the skin.[1],[2] Pemphigus significantly impairs patients' quality of life.[3] A variety of emerging therapeutic options are available for the treatment of pemphigus.[4] To ensure precise comparisons between new and traditional therapies, it is essential to utilize standardized and validated outcome measures. In this issue, Boucher et al. provided a comprehensive review of the currently available scoring systems and the corresponding validation studies for assessing the severity of pemphigus.[5] Pemphigus Disease Area Index and Autoimmune Bullous Skin Disorder Intensity Score are recognized as the most valid and reliable tools for assessing the severity of pemphigus. However, it is important to mention that the U. S. Food and Drug Administration tends to prefer simplified scores, such as Investigator's Global Assessments (IGAs). Nevertheless, additional investigation is required to ascertain the validity and reliability of IGAs as measures of pemphigus severity in clinical trial settings.

  Sex Hormone-related Hair Diseases 

In 1942, Dr. Hamilton, a Yale anatomist, first reported the characteristic patterned hair loss could be induced through the administration of androgens in men with testicular insufficiency.[6] Hormones have a crucial role in regulating hair growth, significantly affecting the hair cycle and follicular architecture. Over the past several decades, we have seen significant progress in the treatment of hair disorders related to hormonal imbalances. However, the underlying causes of some of these conditions remain unclear. Hsieh et al. reviewed the major sex steroid hormones and their systemic and local effects on hair growth.[7] The different responses of animal and human hair follicles to sex hormones, as well as the pathogenesis and treatment of sex hormone-related hair diseases, were also discussed. Finally, future research directions, including sex hormones and the immune system and the potential influence of epigenetics on these hair disorders, were highlighted.

  Platelet-rich Plasma for Alopecia Areata 

Kelleci et al. studied the effectiveness and safety of platelet-rich plasma (PRP) treatment in patients with patch-type alopecia areata (AA).[8] Seventeen patients were recruited, and they received at least three sessions of PRP treatment every 4 weeks. The authors found that PRP is an effective and safe method and can be considered a treatment strategy for AA patients with mild symptoms and short-duration disease.

  Epigenetic Dysregulation in Primary Cutaneous Mucinous Carcinoma 

Epigenetic modifications have been recognized as the key factors in a variety of biological processes and diseases, including skin cancer.[9] Trimethylation of histone H3 at lysine 27 (H3K27 me3) is a key regulator in chromatin remodeling-controlled transcription.[10] Using immunohistochemistry studies, Li et al. found a reduction in H3K27 me3 expression in primary cutaneous mucinous carcinoma (PCMC) compared to other mucinous carcinomas.[11] This pioneering study suggests that epigenetic occurrences may play a part in the pathobiology of PCMC.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 

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