M. Zeidi

Itch in dermatomyositis: the role of increased skin interleukin-31

Interleukin (IL)‐31 is implicated in pruritus associated with pruritic skin diseases like atopic dermatitis. Although pruritus is a prominent feature in dermatomyositis (DM), few studies have evaluated the pathogenesis of DM‐associated itch.

Acute onset/flares of dermatomyositis following ingestion of IsaLean® herbal supplement: clinical and immunostimulatory findings

REFERENCES 1. Miguel-Gomez L, Vano-galvan S, Perez-garcia B, Carrillo-gijon R, Jaen-olasolo P. Treatment of folliculitis decalvans with photodynamic therapy: results in 10 patients. J Am Acad Dermatol. 2015;72(6):1085-1087. 2. Qaseem A, Snow V, Owens DK, Shekelle P. The development of clinical practice guidelines and guidance statements of the American College of Physicians: summary of methods. Ann Intern Med. 2010;153(3):194-199. 3. Vano-Galvan SS.Vano-Galvan, Molina-Ruiz AMA.M.Molina-Ruiz, Fernandez-Crehuet PP.Fernandez-Crehuet, et al. Folliculitis decalvans: a multicentre review of 82 patients. J Eur Acad Dermatol Venereol. 2015;29(9). 2015:1750-1757. 4. Powell JJ, Dawber RP, Gatter K. Folliculitis decalvans including tufted folliculitis: clinical, histological and therapeutic findings. Br J Dermatol. 1999;140(2):328-333. 5. Miguel-Gomez L, Rodrigues-Barata AR, Molina-Ruiz A, et al. Folliculitis decalvans: effectiveness of therapies and prognostic factors in a multicenter series of 60 patients with long-term follow-up. J Am Acad Dermatol. 2018. https: //doi.org/10.1016/j.jaad.2018.05.1240. 6. Tietze JK, Heppt MV, von Preussen A, et al. Oral isotretinoin as the most effective treatment in folliculitis decalvans: a retrospective comparison of different treatment regimens in 28patients. J Eur AcadDermatol Venereol. 2015;29(9):1816-1821. 7. Bunagan MJK, Banka N, Shapiro J. Retrospective Review of folliculitis decalvans in 23 patients with course and treatment analysis of long-standing cases. J Cutan Med Surg. 2015;19(1): 45-49. 8. Aksoy B, Hapa A, Mutlu E. Isotretinoin treatment for folliculitis decalvans: a retrospective case-series study. Int J Dermatol. 2018;57(2):250-253.

Interleukin-31 and itch in dermatomyositis

Patients with dermatomyositis often suffer from itching, but the mechanism is unknown. The authors of this study, based in USA, Korea and Italy, aimed to find out how common itch is in patients with dermatomyositis, and whether a cytokine called IL‐31 is increased in affected skin. Cytokines are proteins produced by cells in the immune system and a delicate balance of cytokines is needed to maintain health. In some skin disorders, such as atopic eczema, this balance is disrupted, and too many pro‐inflammatory cytokines (meaning ones which cause inflammation) are produced. 191 patients with the condition were surveyed, and the authors took biopsy samples from skin lesions, compared with four healthy controls (people without dermatomyositis). They found that half of the patients had moderate to severe itch, and itch was linked to the severity of the disease. In skin lesions from patients with itchy dermatomyositis, there was increased gene expression of IL‐31and its receptor (meaning more IL‐31 and the receptor that helps it work were released), and this expression was stronger in patients with more severe itch. A new drug under investigation for dermatomyositis, lenabasum, reduces or ‘downregulates’ the expression of IL‐31, and the authors conclude that it may prove to be of value in the treatment of itch in this condition.