Immune-Mediated Skin Diseases: From Pathophysiology to Novel Therapeutic Approaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Immunology and Immunotherapy".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 52231

Special Issue Editors

Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
Interests: skin immune-mediated skin diseases; psoriasis; suppurative hidradenitis; chronic urticaria; atopic dermatitis; adnexal diseases; melanoma and non-melanoma skin cancer; scleroderma
Special Issues, Collections and Topics in MDPI journals
Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
Interests: skin immune-mediated skin diseases; psoriasis; suppurative hidradenitis; chronic urticaria; atopic dermatitis; adnexal diseases; auto-inflammatory dermatoses; acne; contact dermatitis; scleroderma
Special Issues, Collections and Topics in MDPI journals
Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
Interests: skin immune-mediated skin diseases; psoriasis; suppurative hidradenitis; chronic urticaria; atopic dermatitis; adnexal diseases; melanoma and non-melanoma skin cancer; scleroderma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Growing interest in the pathogenesis of immune-mediated skin diseases (skin IMIDs) has led to the identification of several inflammatory pathways that are crucial for their development and maintenance.

Morbidity associated with cutaneous IMIDs has been extensively reconsidered following knowledge acquired on the repercussions of these diseases on the general health of patients. All skin IMIDs have large impacts on quality of life, and most are associated with increased risk of developing atherosclerosis, metabolic syndrome, psychological/psychiatric disorders, generalized atopic status, infections, neoplastic risk, and other systemic IMIDs (e.g., diabetes, Crohn's disease, ulceration, colitis, polycystic ovary syndrome, uveitis, asthma).

Dermatologists can be considered sentinel clinicians in the development of systemic involvement related to skin IMIDs, so they can play a significant role in modifying the natural history of skin IMIDs through early recognition, correct patient assessment, and specific therapeutic interventions.

Fortunately, in recent years, research has led to highly effective new treatment options, and others are expected in the near future. However, the following questions remain: What are the main pathological drivers of skin IMIDs? What is the role of the skin microenvironment? What are the mechanisms underlying systemic involvement in skin IMIDs? Are there predictive biomarkers for systemic targeted treatments? Can an early therapeutic intervention really change the natural history of skin IMIDs and their systemic repercussions?

This Special Issue intends to provide plausible answers to these and other questions by presenting the latest research on skin IMIDs, as well as highlighting research gaps that should be addressed in future studies.

Prof. Dr. Anna Campanati
Guest Editor
Dr. Emanuela Martina
Prof. Dr. Annamaria Offidani
Co-Guest Editors

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Keywords

  • Skin immune.-mediated skin diseases
  • psoriasis
  • suppurative hidradenitis
  • atopic dermatitis
  • acne
  • lichen sclerosus
  • skin bullous diseases
  • chronic urticaria
  • neutrophilic dermatoses
  • scleroderma

Related Special Issue

Published Papers (13 papers)

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Editorial

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5 pages, 209 KiB  
Editorial
The Challenge Arising from New Knowledge about Immune and Inflammatory Skin Diseases: Where We Are Today and Where We Are Going
by Anna Campanati, Emanuela Martina and Annamaria Offidani
Biomedicines 2022, 10(5), 950; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines10050950 - 20 Apr 2022
Cited by 4 | Viewed by 1151
Abstract
Skin is the widest and most accessible organ of the human body, and among its functions, the immunological one has been one of the most intriguing and investigated during the last 10 years; so, inflammatory and immune-mediated skin diseases (s-IMID) are considered as [...] Read more.
Skin is the widest and most accessible organ of the human body, and among its functions, the immunological one has been one of the most intriguing and investigated during the last 10 years; so, inflammatory and immune-mediated skin diseases (s-IMID) are considered as useful models to understand which physiopathological pathways are implicated in Th1, Th2, Th17, and Th22 inflammatory diseases [...] Full article

Research

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18 pages, 4276 KiB  
Article
Thalidomide Exerts Anti-Inflammatory Effects in Cutaneous Lupus by Inhibiting the IRF4/NF-ҡB and AMPK1/mTOR Pathways
by Sandra Domingo, Cristina Solé, Teresa Moliné, Berta Ferrer and Josefina Cortés-Hernández
Biomedicines 2021, 9(12), 1857; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9121857 - 07 Dec 2021
Cited by 6 | Viewed by 2856
Abstract
Thalidomide is effective in patients with refractory cutaneous lupus erythematosus (CLE). However, the mechanism of action is not completely understood, and its use is limited by its potential, severe side-effects. Immune cell subset analysis in thalidomide’s CLE responder patients showed a reduction of [...] Read more.
Thalidomide is effective in patients with refractory cutaneous lupus erythematosus (CLE). However, the mechanism of action is not completely understood, and its use is limited by its potential, severe side-effects. Immune cell subset analysis in thalidomide’s CLE responder patients showed a reduction of circulating and tissue cytotoxic T-cells with an increase of iNKT cells and a shift towards a Th2 response. We conducted an RNA-sequencing study using CLE skin biopsies performing a Therapeutic Performance Mapping System (TMPS) analysis in order to generate a predictive model of its mechanism of action and to identify new potential therapeutic targets. Integrating RNA-seq data, public databases, and literature, TMPS analysis generated mathematical models which predicted that thalidomide acts via two CRBN-CRL4A- (CRL4CRBN) dependent pathways: IRF4/NF-ҡB and AMPK1/mTOR. Skin biopsies showed a significant reduction of IRF4 and mTOR in post-treatment samples by immunofluorescence. In vitro experiments confirmed the effect of thalidomide downregulating IRF4 in PBMCs and mTOR in keratinocytes, which converged in an NF-ҡB reduction that led to a resolution of the inflammatory lesion. These results emphasize the anti-inflammatory role of thalidomide in CLE treatment, providing novel molecular targets for the development of new therapies that could avoid thalidomide’s side effects while maintaining its efficacy. Full article
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13 pages, 2394 KiB  
Article
Repeated α-GalCer Administration Induces a Type 2 Cytokine-Biased iNKT Cell Response and Exacerbates Atopic Skin Inflammation in Vα14Tg NC/Nga Mice
by Hyun Jung Park, Tae-Cheol Kim, Yun Hoo Park, Sung Won Lee, Jungmin Jeon, Se-Ho Park, Luc Van Kaer and Seokmann Hong
Biomedicines 2021, 9(11), 1619; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9111619 - 04 Nov 2021
Cited by 10 | Viewed by 1685
Abstract
We have previously shown that Vα14 TCR Tg (Vα14Tg) NC/Nga (NC) mice contain increased numbers of double-negative (DN) invariant natural killer T (iNKT) cells that protect against spontaneous development of atopic dermatitis (AD). iNKT cells can regulate immune responses by producing [...] Read more.
We have previously shown that Vα14 TCR Tg (Vα14Tg) NC/Nga (NC) mice contain increased numbers of double-negative (DN) invariant natural killer T (iNKT) cells that protect against spontaneous development of atopic dermatitis (AD). iNKT cells can regulate immune responses by producing various cytokines such as IFNγ and IL4 rapidly upon stimulation with α-galactosylceramide (α-GalCer), a prototypical iNKT cell agonist. However, the precise role of α-GalCer-activated iNKT cells in AD development remains unclear. Therefore, we examined whether repeated activation of iNKT cells with α-GalCer can regulate the pathogenesis of AD in Vα14Tg NC mice. We found that Vα14Tg NC mice injected repeatedly with α-GalCer display exacerbated AD symptoms (e.g., a higher clinical score, IgE hyperproduction, and increased numbers of splenic mast cells and neutrophils) compared with vehicle-injected Vα14Tg NC mice. Moreover, the severity of AD pathogenesis in α-GalCer-injected Vα14Tg NC mice correlated with increased Th2 cells but reduced Th1 and Foxp3+ Treg cells. Furthermore, the resulting alterations in the Th1/Th2 and Treg/Th2 balance were strongly associated with a biased expansion of type 2 cytokine-deviated iNKT cells in α-GalCer-treated Vα14Tg NC mice. Collectively, our results have demonstrated the adverse effect of repeated α-GalCer treatment on skin inflammation mediated by type 2 immunity. Full article
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15 pages, 299 KiB  
Article
New-Onset Psoriatic Arthritis under Biologics in Psoriasis Patients: An Increasing Challenge?
by Matteo Megna, Sonia Sofia Ocampo-Garza, Luca Potestio, Giuseppina Fontanella, Lucia Gallo, Sara Cacciapuoti, Angelo Ruggiero and Gabriella Fabbrocini
Biomedicines 2021, 9(10), 1482; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9101482 - 15 Oct 2021
Cited by 31 | Viewed by 3027
Abstract
Psoriasis and psoriatic arthritis (PsA) development is sustained by tumor necrosis factor (TNF)α, interleukin (IL)17, and IL23; hence, biologics targeting those cytokines represent useful therapeutic weapons for both conditions. Nevertheless, biologics strongly reduce PsA risk; several studies reported the possibility of new-onset PsA [...] Read more.
Psoriasis and psoriatic arthritis (PsA) development is sustained by tumor necrosis factor (TNF)α, interleukin (IL)17, and IL23; hence, biologics targeting those cytokines represent useful therapeutic weapons for both conditions. Nevertheless, biologics strongly reduce PsA risk; several studies reported the possibility of new-onset PsA during biologic therapy for psoriasis. The aim of this 1-year prospective study is to evaluate the prevalence of paradoxical PsA in psoriasis patients under biologic therapy and review the existing literature. For each patient, age, sex, psoriasis duration, psoriasis severity, comorbidities, and previous and current psoriasis treatments were collected, and each subject was screened for PsA using the Early ARthritis for Psoriatic patient (EARP) questionnaire every 3 months for 1 year. New-onset PsA was diagnosed in 10 (8.5%) out of 118 patients (three male, 30.0%; mean age 44.5 years) involving every different biologic class (anti-TNF, anti-IL12/23, anti-IL17, and anti-IL23). No significant risk factor for new-onset PsA was identified; no significant difference was found comparing patients who developed PsA and subjects who did not develop PsA regarding psoriasis severity, past/current therapies, and comorbidities. Clinicians must keep in mind the possibility of PsA onset also in patients undergoing biologics so that PsA screening should be strongly recommended at each follow-up. Full article

Review

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17 pages, 350 KiB  
Review
Novel Therapeutic Approaches to Psoriasis and Risk of Infectious Disease
by Alfonso Motolese, Manuela Ceccarelli, Laura Macca, Federica Li Pomi, Ylenia Ingrasciotta, Giuseppe Nunnari and Claudio Guarneri
Biomedicines 2022, 10(2), 228; https://doi.org/10.3390/biomedicines10020228 - 21 Jan 2022
Cited by 16 | Viewed by 3833
Abstract
Psoriasis is a chronic immune-mediated skin and joint disease, with a plethora of comorbidities, characterized by a certain genetic predisposition, and a complex pathogenesis based on the IL-23/IL-17 pathway. There is no doubt that the patients affected by psoriasis are more susceptible to [...] Read more.
Psoriasis is a chronic immune-mediated skin and joint disease, with a plethora of comorbidities, characterized by a certain genetic predisposition, and a complex pathogenesis based on the IL-23/IL-17 pathway. There is no doubt that the patients affected by psoriasis are more susceptible to infections as well as that the risk of infection is higher in psoriatic subjects than in the general population. The advent of biotechnological agents on the therapeutic arsenal actually available for the treatment of moderate-to-severe patients, given the fact that the severity of the disease is a predictor of the level of infectious risk, has raised the question of whether these ‘new’ drugs could be considered a safer option and how they can be used in selected cases. Old and newer strategies in cases of chronic infectious conditions are reviewed under the light of clinical trials and other studies present in literature. Full article
21 pages, 1944 KiB  
Review
Systemic Sclerosis: From Pathophysiology to Novel Therapeutic Approaches
by Devis Benfaremo, Silvia Svegliati, Chiara Paolini, Silvia Agarbati and Gianluca Moroncini
Biomedicines 2022, 10(1), 163; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines10010163 - 12 Jan 2022
Cited by 16 | Viewed by 6097
Abstract
Systemic sclerosis (SSc) is a systemic, immune-mediated chronic disorder characterized by small vessel alterations and progressive fibrosis of the skin and internal organs. The combination of a predisposing genetic background and triggering factors that causes a persistent activation of immune system at microvascular [...] Read more.
Systemic sclerosis (SSc) is a systemic, immune-mediated chronic disorder characterized by small vessel alterations and progressive fibrosis of the skin and internal organs. The combination of a predisposing genetic background and triggering factors that causes a persistent activation of immune system at microvascular and tissue level is thought to be the pathogenetic driver of SSc. Endothelial alterations with subsequent myofibroblast activation, excessive extracellular matrix (ECM) deposition, and unrestrained tissue fibrosis are the pathogenetic steps responsible for the clinical manifestations of this disease, which can be highly heterogeneous according to the different entity of each pathogenic step in individual subjects. Although substantial progress has been made in the management of SSc in recent years, disease-modifying therapies are still lacking. Several molecular pathways involved in SSc pathogenesis are currently under evaluation as possible therapeutic targets in clinical trials. These include drugs targeting fibrotic and metabolic pathways (e.g., TGF-β, autotaxin/LPA, melanocortin, and mTOR), as well as molecules and cells involved in the persistent activation of the immune system (e.g., IL4/IL13, IL23, JAK/STAT, B cells, and plasma cells). In this review, we provide an overview of the most promising therapeutic targets that could improve the future clinical management of SSc. Full article
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22 pages, 399 KiB  
Review
Pustular Psoriasis: From Pathophysiology to Treatment
by Giovanni Genovese, Chiara Moltrasio, Nicoletta Cassano, Carlo Alberto Maronese, Gino Antonio Vena and Angelo Valerio Marzano
Biomedicines 2021, 9(12), 1746; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9121746 - 23 Nov 2021
Cited by 36 | Viewed by 4147
Abstract
Pustular psoriasis (PP) is a clinicopathological entity encompassing different variants, i.e., acute generalized PP (GPP), PP of pregnancy (impetigo herpetiformis), annular (and circinate) PP, infantile/juvenile PP, palmoplantar PP/palmoplantar pustulosis, and acrodermatitis continua of Hallopeau (ACH), which have in common an eruption of superficial [...] Read more.
Pustular psoriasis (PP) is a clinicopathological entity encompassing different variants, i.e., acute generalized PP (GPP), PP of pregnancy (impetigo herpetiformis), annular (and circinate) PP, infantile/juvenile PP, palmoplantar PP/palmoplantar pustulosis, and acrodermatitis continua of Hallopeau (ACH), which have in common an eruption of superficial sterile pustules on an erythematous base. Unlike psoriasis vulgaris, in which a key role is played by the adaptive immune system and interleukin (IL)-17/IL-23 axis, PP seems to be characterized by an intense inflammatory response resulting from innate immunity hyperactivation, with prominent involvement of the IL-36 axis. Some nosological aspects of PP are still controversial and debated. Moreover, owing to the rarity and heterogeneity of PP forms, data on prognosis and therapeutic management are limited. Recent progresses in the identification of genetic mutations and immunological mechanisms have promoted a better understanding of PP pathogenesis and might have important consequences on diagnostic refinement and treatment. In this narrative review, current findings in the pathogenesis, classification, clinical features, and therapeutic management of PP are briefly discussed. Full article
16 pages, 978 KiB  
Review
Immunological Targets of Biologic Drugs in Allergic Skin Diseases in Children
by Paola Di Filippo, Daniele Russo, Marina Attanasi, Sabrina Di Pillo and Francesco Chiarelli
Biomedicines 2021, 9(11), 1615; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9111615 - 04 Nov 2021
Cited by 7 | Viewed by 2243
Abstract
Atopic dermatitis and urticaria are two invalidating skin disorders that are very common in children. Recent advances in the understanding of their specific intracellular molecular pathways have permitted the development of precise biological molecules, targeting inflammatory mediators and arresting the pathogenetic pathways of [...] Read more.
Atopic dermatitis and urticaria are two invalidating skin disorders that are very common in children. Recent advances in the understanding of their specific intracellular molecular pathways have permitted the development of precise biological molecules, targeting inflammatory mediators and arresting the pathogenetic pathways of skin diseases. Many biologics with promising results have been studied, although few are currently approved in children. In this review, we aim to provide the latest evidence about the use, indications, efficacy and safety of biologic therapies to treat atopic dermatitis and chronic urticaria in children and adolescents. Full article
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20 pages, 373 KiB  
Review
Psoriasis as an Immune-Mediated and Inflammatory Systemic Disease: From Pathophysiology to Novel Therapeutic Approaches
by Anna Campanati, Andrea Marani, Emanuela Martina, Federico Diotallevi, Giulia Radi and Annamaria Offidani
Biomedicines 2021, 9(11), 1511; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9111511 - 21 Oct 2021
Cited by 37 | Viewed by 3272
Abstract
Psoriasis is an immune-mediated inflammatory disease, with a chronic relapsing-remitting course, which affects 2–3% of the worldwide population. The progressive acquisitions of the inflammatory pathways involved in the development of psoriasis have led to the identification of the key molecules of the psoriatic [...] Read more.
Psoriasis is an immune-mediated inflammatory disease, with a chronic relapsing-remitting course, which affects 2–3% of the worldwide population. The progressive acquisitions of the inflammatory pathways involved in the development of psoriasis have led to the identification of the key molecules of the psoriatic inflammatory cascade. At the same time, psoriasis therapy has radically evolved with the introduction of target molecules able to modify the natural history of the disease, acting specifically on these inflammatory pathways. For these reasons, biologics have been demonstrated to be drugs able to change the disease’s natural history, as they reduce the inflammatory background to avoid irreversible organ damage and prevent systemic complications. However, several issues related to the use of biologics in patients with systemic comorbidities, remain open. All these data reflect the extraordinary potentiality of biologics, but also the unmet medical need to improve our knowledge on the long-term risk related to continuous use of these drugs, and their administration in special populations. This narrative review aims to highlight both the efficacy and safety profile of biologics in psoriasis, starting from pathophysiology and moving towards their clinical application. Full article
33 pages, 1433 KiB  
Review
Insights into the Pathogenesis of HS and Therapeutical Approaches
by Elia Rosi, Maria Thais Fastame, Ilaria Scandagli, Antonella Di Cesare, Federica Ricceri, Nicola Pimpinelli and Francesca Prignano
Biomedicines 2021, 9(9), 1168; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9091168 - 06 Sep 2021
Cited by 16 | Viewed by 4542
Abstract
Hidradenitis suppurativa (HS) is a debilitating, chronic, (auto)inflammatory disease primarily affecting apocrine gland-rich areas of the body. Although pathogenic mechanisms responsible for HS have not yet been fully elucidated, it is a multifactorial process whose main target is the terminal follicle. The role [...] Read more.
Hidradenitis suppurativa (HS) is a debilitating, chronic, (auto)inflammatory disease primarily affecting apocrine gland-rich areas of the body. Although pathogenic mechanisms responsible for HS have not yet been fully elucidated, it is a multifactorial process whose main target is the terminal follicle. The role of the inflammatory process (and consequently of cytokine milieu) and of several other factors (genetics, lifestyle, hormonal status, microbiome, innate and adaptive immune systems) involved in HS pathogenesis has been investigated (and often defined) over the years with a view to transferring research results from bench to bedside and describing a unique and universally accepted pathogenetic model. This review will update readers on recent advances in our understanding of HS pathogenesis and novel (potential) medical therapies for patients with moderate-to-severe HS. Full article
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24 pages, 4125 KiB  
Review
Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects
by Monica Corazza, Natale Schettini, Pierantonia Zedde and Alessandro Borghi
Biomedicines 2021, 9(8), 950; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9080950 - 03 Aug 2021
Cited by 27 | Viewed by 11698
Abstract
Vulvar lichen sclerosus (VLS) is a chronic, distressing, inflammatory disease with an enormous impact on quality of life. Treatment goals are relieving symptoms, reversing signs and preventing anatomical changes. Despite the availability of numerous therapeutic options, treatment outcome may not be entirely satisfactory [...] Read more.
Vulvar lichen sclerosus (VLS) is a chronic, distressing, inflammatory disease with an enormous impact on quality of life. Treatment goals are relieving symptoms, reversing signs and preventing anatomical changes. Despite the availability of numerous therapeutic options, treatment outcome may not be entirely satisfactory and a definitive cure does not exist. This may be due to the fact that the exact VLS etiopathogenesis remains unknown. The objectives of this paper were to review the most up-to-date knowledge on VLS etiopathogenesis and to consider the available therapies through the lens of a plausible pathogenetic model. An electronic search on both VLS etiopathogenesis and its treatment was performed using the National Library of Medicine PubMed database. Based on current knowledge, it is conceivable that various, heterogeneous environmental factors acting on a genetic background trigger an autoimmune, Th-1 response, which leads to a chronic inflammatory state. This, in turn, can determine both tissue and micro-vascular injury and activation of signaling pathways involved in fibroblast and collagen metabolism. This pathogenetic sequence may explain the effectiveness of anti-inflammatory treatments, mostly topical corticosteroids, in improving VLS clinical-pathological changes. Further deepening of the disease pathways will presumably allow key mediators to become new therapeutic targets and optimize the available treatments. Full article
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11 pages, 636 KiB  
Systematic Review
Paradoxical Hidradenitis Suppurativa during Biologic Therapy, an Emerging Challenge: A Systematic Review
by Angelo Ruggiero, Fabrizio Martora, Vincenzo Picone, Laura Marano, Gabriella Fabbrocini and Claudio Marasca
Biomedicines 2022, 10(2), 455; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines10020455 - 16 Feb 2022
Cited by 34 | Viewed by 3479
Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease usually occurring after puberty with painful, deep-seated, inflammatory lesions in the apocrine gland-bearing areas of the body. Although HS pathogenesis is still unproven, recent major research advantages have increased our knowledge of the mechanisms [...] Read more.
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease usually occurring after puberty with painful, deep-seated, inflammatory lesions in the apocrine gland-bearing areas of the body. Although HS pathogenesis is still unproven, recent major research advantages have increased our knowledge of the mechanisms behind HS lesions. Particularly, follicular occlusion followed by follicular rupture has been shown to be crucial to HS development, leading to immune response activation, and resulting in typical clinical HS lesions. Moreover, an increased and imbalanced cytokine production, such as interleukin (IL) 17 and tumor necrosis factor (TNF) α, may play a role in HS. In recent years, paradoxical adverse events have been described during treatment. Since the recent increased use of biologic treatments in HS, an increased number of paradoxical HS occurrences have been reported. In this review, we analyzed all current data on paradoxical HS triggered by biological drugs. Full article
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15 pages, 620 KiB  
Systematic Review
Neoplastic Implications in Patients Suffering from Hidradenitis Suppurativa under Systemic Treatments
by Federica Li Pomi, Laura Macca, Alfonso Motolese, Ylenia Ingrasciotta, Massimiliano Berretta and Claudio Guarneri
Biomedicines 2021, 9(11), 1594; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines9111594 - 01 Nov 2021
Cited by 10 | Viewed by 2352
Abstract
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease of the apocrine glands. It typically involves the axillary, submammary, genital, inguinal, perineal, and perianal regions. The development of abscesses, sinus tracts, and scars can lead to pain, scarring, disfigurement and decreased quality [...] Read more.
Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory skin disease of the apocrine glands. It typically involves the axillary, submammary, genital, inguinal, perineal, and perianal regions. The development of abscesses, sinus tracts, and scars can lead to pain, scarring, disfigurement and decreased quality of life. HS is associated with a wide range of comorbidities. Several studies of co-occurrence of HS and nonmelanoma skin cancer suggest a causal relationship. In an attempt to assess the link between HS and cancer, we performed a systematic review of the current scientific knowledge through a PubMed-based literature search. Results show that HS could be associated with an overall risk of cancer and numerous specific cancers such as: nonmelanoma skin cancer (NMSC), hematologic malignancies, and metastatic cancer. Among NMSC, squamous cell carcinoma (SCC) is considered the most common complication arising in long-standing HS. Based on our review, we suggest that cautious surveillance and active intervention may be warranted in patients with HS. Moreover, an age-appropriate cancer screening should be offered to all patients, especially those who developed HS later in their life or in long-standing moderate to severe HS with multiple comorbidities. Full article
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