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Recent Advances in Inflammatory and Infectious Skin Diseases
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Recent Advances in Inflammatory and Infectious Skin Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (25 May 2024) | Viewed by 3164

Special Issue Editors

Dr. Giulia Ciccarese

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Guest Editor
Unit of Dermatology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
Interests: skin and mucosal infections; sexually transmitted infections; infectious exanthems; human papillomaviruses; syphilis
Special Issues, Collections and Topics in MDPI journals
Dr. Astrid Herzum

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Guest Editor
Dermatology Unit, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, 16147 Genova, Italy
Interests: dermatology; infectious skin disease; inflammatory skin disease
Special Issues, Collections and Topics in MDPI journals
Dr. Gianmaria Viglizzo

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Guest Editor
Dermatology Unit, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5, 16147 Genova, Italy
Interests: autoinflammatory diseases; clinical dermatology; infectious skin disease; inflammatory skin disease

Special Issue Information

Dear Colleagues,

Inflammatory skin diseases represent the largest class of skin disease, affecting up to 20-25% of the population at all stages of life. Among inflammatory skin diseases, atopic dermatitis in particular causes a high disease burden, and encompasses also the pediatric field, affecting up to 30% of the pediatric population, as well as 2-10% of adults. In addition, other eczematous diseases are exhibited, such as seborrheic dermatitis and psoriasis, as well as lichen and lichenoid dermatoses, urticaria and urticarial rashes, hidradenitis suppurativa, acne, rosacea, autoimmune diseases, drug reactions and reactions to toxins. These represent only part of the vast number of inflammatory skin diseases that are the primary focus of this Special Issue, which includes a discussion of their clinical presentation, either acute or more frequently chronic, and their ability to be characterized by recurrent relapses and acute flare-ups. In this Special Issue, the submission of articles providing a detailed outline of the pathogenetic mechanisms involved, either autoimmune or in response to infectious diseases, as well as these diseases’ complications, diagnosis and therapy, is welcome. Inflammatory dermatoses, especially if chronic, highly impact the life quality of patients and still present many unsatisfied needs; therefore, continuous therapeutic evolution deserves in-depth debate and space in this  Special Issue.

As for infectious diseases of the skin, these are indeed closely connected with cutaneous inflammatory diseases. In fact, there are many systemic infections that may cause inflammatory skin conditions: among the viral infections, human herpesvirus 6 and/or 7 are responsible for the exanthema subitum and their reactivation is the cause of pityriasis rosea; and among the bacterial infections, Treponema pallidum causes an inflammatory cutaneous manifestation known as “roseola syphilitica”.

Moreover, several common inflammatory diseases of the skin can be triggered or worsened by infections (guttate psoriasis, atopic dermatitis and others).

Overall, this Special Issue aims to provide an update on the most recent research in the field of inflammatory and infectious skin diseases and their possible interconnections, pathogenesis, complications, and therapies.

Dr. Giulia Ciccarese
Dr. Astrid Herzum
Dr. Gianmaria Viglizzo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • atopic dermatitis
  • eczematous diseases
  • inflammatory skin diseases
  • chronic skin diseases
  • human herpesvirus
  • roseola syphilitica
  • psoriasis

Published Papers (5 papers)

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Research

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19 pages, 22429 KiB  
Article
Impact of Upadacitinib on Atopic Keratoconjunctivitis Exacerbated by Dupilumab Treatment in Atopic Dermatitis Patients: A Prospective Dermatological and Ophthalmological Clinical Evaluation in Common Clinical Practice
by Claudia Paganini, Sara Spelta, Lorenzo Tofani, Marina Talamonti, Luca Bianchi, Marco Coassin, Antonio Di Zazzo and Marco Galluzzo
J. Clin. Med. 2024, 13(13), 3818; https://doi.org/10.3390/jcm13133818 - 28 Jun 2024
Viewed by 466
Abstract
Introduction: Atopic dermatitis (AD) is a prevalent chronic inflammatory skin condition with a substantial impact on patients, particularly due to ocular involvement known as atopic keratoconjunctivitis (AKC). Current therapeutic approaches, such as dupilumab, often lead to conjunctivitis, prompting exploration of alternative treatments like [...] Read more.
Introduction: Atopic dermatitis (AD) is a prevalent chronic inflammatory skin condition with a substantial impact on patients, particularly due to ocular involvement known as atopic keratoconjunctivitis (AKC). Current therapeutic approaches, such as dupilumab, often lead to conjunctivitis, prompting exploration of alternative treatments like upadacitinib. Methods: We collected dermatological and ophthalmological prospective clinical evaluations of six adults with moderate-to-severe AD, undergoing treatment with upadacitinib after discontinuation of dupilumab due to the onset of AKC during therapy and the worsening of dermatitis in particular in the head and neck region. Clinical evaluations, including EASI scores, itch and sleep NRS, DLQI, and ocular parameters, were performed at baseline (during screening assessment before switching to upadacitinib) and then at week 12 and week 24. Clinical evaluation of AKC was performed by a team of ophthalmologists. Results: Upadacitinib not only improved atopic dermatitis in terms of EASI, itching, and sleep NRS, but also demonstrated a notable reduction in ocular signs and symptoms, as indicated by the Visual Analogue Scale (VAS), the Efron scale, and the Ocular Surface Disease Index Symptom Severity (OSDISS) scores. Discussion: Our observation of common clinical practice underscores the substantial impact of biological and small-molecule therapies on AD, emphasizing the limitation posed by dupilumab-associated conjunctivitis. Switching to upadacitinib significantly improved both clinical and functional ocular outcomes, suggesting its potential as an alternative therapeutic option for AD patients with ocular involvement. Conclusion: The presented data provides insights into the complex interplay between systemic therapies and ocular manifestations in AD. Upadacitinib emerges as a promising option to address dupilumab-associated conjunctivitis, offering improved quality of life for patients. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory and Infectious Skin Diseases)
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17 pages, 7426 KiB  
Article
Eosinophilic Dermatosis of Hematologic Malignancy: Emerging Evidence for the Role of Insect Bites—A Retrospective Clinico-Pathological Study of 35 Cases
by Andrea Michelerio, Marco Rubatto, Gabriele Roccuzzo, Marta Coscia, Pietro Quaglino and Carlo Tomasini
J. Clin. Med. 2024, 13(10), 2935; https://doi.org/10.3390/jcm13102935 - 16 May 2024
Viewed by 589
Abstract
Background/Objectives: Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare cutaneous disorder associated with various hematologic malignancies, most commonly chronic lymphocytic leukemia. Detailed clinicopathologic studies of EDHM are lacking and the pathogenesis remains enigmatic. Initially thought to be a hypersensitivity reaction to insect [...] Read more.
Background/Objectives: Eosinophilic dermatosis of hematologic malignancy (EDHM) is a rare cutaneous disorder associated with various hematologic malignancies, most commonly chronic lymphocytic leukemia. Detailed clinicopathologic studies of EDHM are lacking and the pathogenesis remains enigmatic. Initially thought to be a hypersensitivity reaction to insect stings, subsequent reports have challenged this understanding. The prognostic implications of EDHM remain unclear. Methods: A retrospective clinicopathologic study was performed on patients diagnosed with EDHM. Hematologic and dermatologic data were reviewed. Histologic specimens were re-evaluated and lesions were classified into acute/subacute, fully developed, and chronic/regressing. Results: The study included 35 patients. In 80% of these patients, EDHM was diagnosed after the hematologic disorder. Approximately 45% of the cohort experienced hematologic disease progression or relapse, while 65% required therapeutic intervention during the course of their hematologic disease. In total, 15/19 CLL patients had non-mutated IgHV, a marker of a more aggressive hematologic disease course. Dermatologic lesion morphology was heterogeneous, with most lesions occurring on exposed areas, and a significant 94% of patients demonstrated lesion seasonality. Histopathologic findings were consistent with features typically associated with insect bites. In addition, examination of lesions at different chronological stages revealed substantial similarities with Wells syndrome. Conclusions: Our findings support the potential role of insect bites in triggering EDHM in the context of adaptive immune dysfunction. EDHM may be associated with a more aggressive disease course or may be a marker of disease progression. The observed co-occurrence of features typical of Wells syndrome in EDHM patients suggests that these conditions are part of a spectrum of disorders that vary in clinical expression. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory and Infectious Skin Diseases)
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11 pages, 759 KiB  
Article
Corticophobia among Parents of Children with Atopic Dermatitis: Assessing Major and Minor Risk Factors for High TOPICOP Scores
by Astrid Herzum, Corrado Occella, Lodovica Gariazzo, Carlotta Pastorino and Gianmaria Viglizzo
J. Clin. Med. 2023, 12(21), 6813; https://doi.org/10.3390/jcm12216813 - 27 Oct 2023
Cited by 1 | Viewed by 874
Abstract
Corticophobia, fear of applying topical corticosteroids (TCSs), is a rising issue in industrialized countries, despite the actual safety of TCSs for atopic dermatitis (AD). Patients attending the Pediatric Dermatology Unit for skin examination were screened for AD. AD patients were included, and data [...] Read more.
Corticophobia, fear of applying topical corticosteroids (TCSs), is a rising issue in industrialized countries, despite the actual safety of TCSs for atopic dermatitis (AD). Patients attending the Pediatric Dermatology Unit for skin examination were screened for AD. AD patients were included, and data were collected. Parental corticophobia was evaluated through the Topical Corticosteroid Phobia (TOPICOP) questionnaire. The χ2 test and logistic regression were used to analyze statistical associations between parental corticophobia (mild/moderate vs. severe) and patients’ and parents’ characteristics. Overall, 100 patients were included (53 females; 47 males; mean age 5.9 years): 44 had mild/moderate AD (EASI ≤ 21), and 56 had severe AD (EASI > 21) (mean EASI 19.7). Of the patients, 33 never consulted healthcare providers for AD, and 67 did. Parental education was low/intermediate in 60 cases and high (gymnasium/university degree) in 40. Mean parental DLQI was 10.7. Mean parental TOPICOP was 39.1%: 51 had mild/moderate corticophobia (TOPICOP ≤ 50%), and 49 had severe corticophobia (TOPICOP > 50%). At the χ2 test, corticophobia was associated with mild/moderate AD (OR 20.9487; 95% CI 7.2489–60.5402; p < 0.001), older age of patients (OR 4.1176; 95% CI 1.7880 to 9.4828; p < 0.001), early disease onset (OR 9.8925; 95% CI 2.7064–36.1596; p < 0.001), and previous healthcare professional consultations (OR 4.9279; 95% CI 1.9335–12.5597; p < 0.001). Also, severe parental corticophobia was very significantly associated with severe parental involvement of life quality (OR 33.3333; 95% CI 10.9046–101.8937; p < 0.001) and with high education of parents (gymnasium or university degree) (29/49) (OR 5.2727; 95% CI 2.1927–12.6790; p < 0.001). At logistic regression, high parental DLQI (p < 0.0001), high parental education (p < 0.0338), older age of patients (p = 0.0015), and early disease onset (p < 0.0513) accounted for major risk factors influencing severe parental corticophobia. Assessing risk factors for corticophobia is essential for addressing groups of parents at higher risk for corticophobia using educational programs, to overcome unfounded fears and augment treatment adherence. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory and Infectious Skin Diseases)
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Review

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16 pages, 794 KiB  
Review
Monoclonal Antibodies in the Management of Inflammation in Wound Healing: An Updated Literature Review
by Flavia Manzo Margiotta, Alessandra Michelucci, Cristian Fidanzi, Giammarco Granieri, Giorgia Salvia, Matteo Bevilacqua, Agata Janowska, Valentina Dini and Marco Romanelli
J. Clin. Med. 2024, 13(14), 4089; https://doi.org/10.3390/jcm13144089 - 12 Jul 2024
Viewed by 348
Abstract
Chronic wounds pose a significant clinical challenge due to their complex pathophysiology and the burden of long-term management. Monoclonal antibodies (mAbs) are emerging as a novel therapeutic option in managing difficult wounds, although comprehensive data on their use in wound care are lacking. [...] Read more.
Chronic wounds pose a significant clinical challenge due to their complex pathophysiology and the burden of long-term management. Monoclonal antibodies (mAbs) are emerging as a novel therapeutic option in managing difficult wounds, although comprehensive data on their use in wound care are lacking. This study aimed to explore existing scientific knowledge of mAbs in treating chronic wounds based on a rationale of direct inhibition of the main molecules involved in the underlying inflammatory pathophysiology. We performed a literature review excluding primary inflammatory conditions with potential ulcerative outcomes (e.g., hidradenitis suppurativa). mAbs were effective in treating wounds from 16 different etiologies. The most commonly treated conditions were pyoderma gangrenosum (treated with 12 different mAbs), lipoid necrobiosis, and cutaneous vasculitis (each treated with 3 different mAbs). Fourteen mAbs were analyzed in total. Rituximab was effective in 43.75% of cases (7/16 diseases), followed by tocilizumab (25%, 4/16 diseases), and both etanercept and adalimumab (18.75%, 3/16 conditions each). mAbs offer therapeutic potential for chronic wounds unresponsive to standard treatments. However, due to the complex molecular nature of wound healing, no single target molecule can be identified. Therefore, the use of mAbs should be considered as a translational approach for limited cases of multi-resistant conditions. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory and Infectious Skin Diseases)
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15 pages, 3168 KiB  
Review
Pyoderma Gangrenosum, a Challenging Postpartum Diagnosis—Case Report and Literature Review
by Daniela Roxana Matasariu, Iuliana Elena Bujor, Elena Mihălceanu, Tudor Cătălin Gîscă, Alina Stâncanu, Elena Corina Andriescu, Ioana Popescu, Demetra Socolov, Ciprian Vasiluță and Alexandra Ursache
J. Clin. Med. 2024, 13(13), 3653; https://doi.org/10.3390/jcm13133653 - 22 Jun 2024
Viewed by 500
Abstract
Background/Objectives: The infrequent occurrence of pyoderma gangrenosum (PG) during pregnancy and in postpartum, with its subsequent diagnostic intricacies, caused us to present the following case. Methods: This article describes a rare case of PG in postpartum in a patient without any [...] Read more.
Background/Objectives: The infrequent occurrence of pyoderma gangrenosum (PG) during pregnancy and in postpartum, with its subsequent diagnostic intricacies, caused us to present the following case. Methods: This article describes a rare case of PG in postpartum in a patient without any prior pathology and a short review of the literature, aiming to identify similar rare instances. Results: We conducted a literature review to ascertain the prevalence of postpartum pyoderma gangrenosum, and we identified a total of 41 cases. Conclusions: Our article underlines again the importance of interdisciplinary collaboration for the prompt identification and commencement of necessary therapeutic interventions in postpartum women afflicted by pyoderma gangrenosum. Full article
(This article belongs to the Special Issue Recent Advances in Inflammatory and Infectious Skin Diseases)
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