Current Concepts on the Pathogenesis of Systemic Sclerosis
AbstractFrom the clinical standpoint, systemic sclerosis (SSc) is characterized by skin and internal organ fibrosis, diffuse fibroproliferative vascular modifications, and autoimmunity. Clinical presentation and course are highly heterogenous and life expectancy variably affected mostly dependent on lung and heart involvement. SSc touches more women than men with differences in disease severity and environmental exposure. Pathogenetic events originate from altered homeostasis favored by genetic predisposition, environmental cues and a variety of endogenous and exogenous triggers. Epigenetic modifications modulate SSc patho...
Source: Clinical Reviews in Allergy and Immunology - September 6, 2021 Category: Allergy & Immunology Source Type: research

Challenge of Nail Psoriasis: An Update Review
AbstractNail psoriasis is a refractory disease that affects 50 –79% skin psoriasis patients and up to 80% of patients with psoriatic arthritis (PsA). The pathogenesis of nail psoriasis is still not fully illuminated, although some peculiar inflammatory cytokines and chemokines seems to be the same as described in psoriatic skin lesions. Psoriatic nail involvi ng matrix can cause pitting, leukonychia, red spots in lunula, and nail plate crumbling, while nail bed involvement can result in onycholysis, oil-drop discoloration, nail bed hyperkeratosis, and splinter hemorrhages. The common assessment methods of evaluating nail...
Source: Clinical Reviews in Allergy and Immunology - September 3, 2021 Category: Allergy & Immunology Source Type: research

Therapeutic Approaches to Systemic Sclerosis: Recent Approvals and Future Candidate Therapies
AbstractSystemic sclerosis is the rheumatic disease with the highest individual mortality. The severity of the disease is determined by the extent of fibrotic changes to cutaneous and internal organ tissues, the most life-threatening visceral manifestations being interstitial lung disease, SSc-associated-pulmonary arterial hypertension and myocardial involvement. The heterogeneity of the disease has initially hindered the design of successful clinical trials, but considerations on classification criteria have improved patient selection in trials, allowing the identification of more homogeneous groups of patients based on p...
Source: Clinical Reviews in Allergy and Immunology - September 1, 2021 Category: Allergy & Immunology Source Type: research

Serum ANCA as Disease Biomarkers: Clinical Implications Beyond Vasculitis
AbstractUsually associated with autoimmune diseases, anti-neutrophil cytoplasmic antibodies are also detected in other conditions, such as infections, malignancies, and after intake of certain drugs. Even if the mechanisms of production and their pathogenic role have not been fully elucidated yet, ANCA are widely recognized as a clinically alarming finding due to their association with various disorders. While ANCA target several autoantigens, proteinase-3, and myeloperoxidase are the ones proved to be most frequently related to chronic inflammation and tissue damage in murine models. Albeit these autoantibodies could be p...
Source: Clinical Reviews in Allergy and Immunology - August 30, 2021 Category: Allergy & Immunology Source Type: research

Defects of the Innate Immune System and Related Immune Deficiencies
AbstractThe innate immune system is the host ’s first line of defense against pathogens. Toll-like receptors (TLRs) are pattern recognition receptors that mediate recognition of pathogen-associated molecular patterns. TLRs also activate signaling transduction pathways involved in host defense, inflammation, development, and the production of inflammatory cytokines. Innate immunodeficiencies associated with defective TLR signaling include mutations inNEMO,IKBA,MyD88, andIRAK4. Other innate immune defects have been associated with susceptibility to herpes simplex encephalitis, viral infections, and mycobacterial disease, a...
Source: Clinical Reviews in Allergy and Immunology - August 21, 2021 Category: Allergy & Immunology Source Type: research

Alopecia Areata: an Update on Etiopathogenesis, Diagnosis, and Management
AbstractAlopecia areata (AA) is a common chronic tissue-specific autoimmune disease, resulting in hair loss, that affects up to 2% of the general population. The exact pathobiology of AA has still remained elusive, while the common theory is the collapse of the immune privilege of the hair follicle caused by immunological mechanism. Multiple genetic and environment factors contribute to the pathogenesis of AA. There are several clinical treatments for AA, varying from one or multiple well-defined patches to more diffuse or total hair loss of the scalp (alopecia totalis) or hair loss of the entire body (alopecia universalis...
Source: Clinical Reviews in Allergy and Immunology - August 17, 2021 Category: Allergy & Immunology Source Type: research

Correction to: Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo
(Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - August 6, 2021 Category: Allergy & Immunology Source Type: research

Comparison of Guidelines for Management of Pemphigus: a Review of Systemic Corticosteroids, Rituximab, and Other Immunosuppressive Therapies
AbstractPemphigus is a severe autoimmune bullous dermatosis that affects the skin and/or mucosa, and it may be life-threatening without proper treatment. The guidelines and/or consensus statements for treatment vary widely between groups. We selected 6 guidelines and consensus statements established by different associations about the management of pemphigus vulgaris (PV) and/or pemphigus foliaceus (PF) to review, compare, and contrast the similarities and differences of these recommendations and provide optimal management suggestions to physicians. Corticosteroids remain a first-line therapy for pemphigus, but there are m...
Source: Clinical Reviews in Allergy and Immunology - August 4, 2021 Category: Allergy & Immunology Source Type: research

Update on the Pathogenesis and Therapy of Atopic Dermatitis
AbstractAtopic dermatitis (AD) is a common inflammatory skin disorder characterized by recurrent eczematous lesions and intense itch. Although it most often starts in infancy and affects children, it is also highly prevalent in adults. In this article, the main aspects of AD have been updated, with a focus on the pathogenetic and therapeutic aspects. The pathogenesis of AD is complex, and it is evident that a strong genetic predisposition, epidermal dysfunction, skin microbiome abnormalities, immune dysregulation, and the neuroimmune system are critical in AD development. Mutations in the genes associated with disrupted ep...
Source: Clinical Reviews in Allergy and Immunology - August 2, 2021 Category: Allergy & Immunology Source Type: research

Systemic Contact Dermatitis: The Routes of Allergen Entry
AbstractSystemic contact dermatitis (SCD) is a generalized reactivation of type IV hypersensitivity skin diseases in individuals with previous sensitization after a contact allergen is administered systemically. Patients with SCD may consider their dermatitis unpredictable and recalcitrant since the causative allergens are difficult to find. If a patient has a pattern of dermatitis suggestive of SCD but fails to improve with conventional treatment, SCD should be taken into consideration. If doctors are not familiar with the presentations of SCD and the possible routes of allergen sensitization and exposure, the diagnosis o...
Source: Clinical Reviews in Allergy and Immunology - August 2, 2021 Category: Allergy & Immunology Source Type: research

Hypersensitivity Reactions to Platinum Agents and Taxanes
AbstractHypersensitivity reactions (HSRs) to chemotherapy agents can present a serious challenge to treating patients with preferred or first-line therapies. Allergic reactions through an immunologic mechanism have been established for platinum and taxane agents, which are used to treat a wide variety of cancers including gynecologic cancers. Platin HSRs typically occur after multiple cycles of chemotherapy, reflecting the development of drug IgE sensitization, while taxane HSRs often occur on first or second exposure. Despite observed differences between platin and taxane HSRs, drug desensitization has been an effective m...
Source: Clinical Reviews in Allergy and Immunology - August 2, 2021 Category: Allergy & Immunology Source Type: research

Hypersensitivity and Immune-related Adverse Events in Biologic Therapy
AbstractBiologic medications are an expanding field of therapeutics for various medical conditions including cancer and inflammatory diseases. Due to their targeted approach to therapy, biologics can be less toxic than traditional systemic medications. However, as use becomes more widespread, adverse effects from biologic administration have also become apparent. Immune-related adverse events are a common mechanism by which biologics can cause on-target immune-related toxicities and both immediate and delayed-type hypersensitivity reactions. Immediate hypersensitivity reactions can be mediated by cytokine release or antibo...
Source: Clinical Reviews in Allergy and Immunology - July 28, 2021 Category: Allergy & Immunology Source Type: research

Newborn Screening in the Diagnosis of Primary Immunodeficiency
This article provides an overview of newborn screening for SCID, recommended steps for follow-up testing and early intervention as well as long-term follow-up. Numerous challenges remain, including the development of clinical consensus regarding confirmatory and diagnostic testing, early interventions, and best practices for immune reconstitution in affected infants. (Source: Clinical Reviews in Allergy and Immunology)
Source: Clinical Reviews in Allergy and Immunology - July 22, 2021 Category: Allergy & Immunology Source Type: research

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo
AbstractVitiligo is an autoimmune disease of the skin characterized by epidermal melanocyte loss resulting in white patches, with an approximate prevalence of 0.5 –2% worldwide. Several precipitating factors by chemical exposure and skin injury present commonly in patients with vitiligo. Although the diagnosis appears to be straightforward for the distinct clinical phenotype and specific histological features, vitiligo provides many challenges including chr onicity, treatment resistance, frequent relapse, associated profound psychosocial effect, and negative impact on quality of life. Multiple mechanisms are involved in ...
Source: Clinical Reviews in Allergy and Immunology - July 20, 2021 Category: Allergy & Immunology Source Type: research

Current Perspectives on Severe Drug Eruption
Abstract Adverse drug reactions involving the skin are commonly known as drug eruptions. Severe drug eruption may cause severe cutaneous adverse drug reactions (SCARs), which are considered to be fatal and life-threatening, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS). Although cases are relatively rare, approximately 2% of hospitalized patients are affected by SCARs. There is an incidence of 2 to 7 cases/million per year of SJS/TEN and 1/1000 to 1/10,000 exposures to offend...
Source: Clinical Reviews in Allergy and Immunology - July 17, 2021 Category: Allergy & Immunology Source Type: research