Rochelle R. Torgerson

Lifetime Incidence Risk of Alopecia Areata Estimated at 2.1% by Rochester Epidemiology Project, 1990–2009

Alopecia Areata (AA) is characterized by patchy, nonscarring, autoimmune-mediated hair loss, although many aspects of AA pathogenesis are unknown (Gilhar et al., 2012). The scalp is most commonly involved in clinically treated AA, but any hair-bearing surface of the body may be affected (Wasserman et al., 2007). Males and females of any age and hair color can have AA (Finner, 2011; Kyriakis et al., 2009). According to the First National Health and Nutrition Examination Survey conducted in the early 1970s, AA is fairly common; it was estimated to affect about 2 of every 1,000 people in the United States (Safavi, 1992). Dermatologists encounter AA in 0.7% to 4.0% of their patient populations (Price, 1991; Sharma et al., 1996; Tan et al., 2002). A previous study reported by Mayo Clinic and National Institutes of Health (Safavi et al., 1995) showed that the overall incidence of AA in Olmsted County, Minnesota, was 20.2 per 100,000 person-years from 1975 through 1989. A similar incidence rate for both sexes with a lifetime risk of 1.7% was observed.

Burning mouth syndrome.

Burning mouth syndrome (BMS) is a chronic condition characterized by burning of the oral mucosa, with or without dysgeusia and xerostomia, in the setting of no underlying systemic disease or identifiable abnormalities on physical examination or laboratory testing. BMS disproportionately affects postmenopausal women. The pathophysiology of the disease is unknown; no single treatment has proven universally successful. In light of these shortcomings, having a practical approach to the evaluation and management of patients with BMS can improve both patient quality of life and physician satisfaction.

Agonist-induced changes in cell shape during regulated secretion in rat pancreatic acini.

The actin cytoskeleton plays an important role in the mediation of exocytosis and the determination of cell shape. Experimentally induced changes in cell shape have been shown to affect stimulated secretion in pancreatic acini. In this study, we have examined whether physiologic agonists induce changes in acinar cell shape to modulate secretion. Computer‐enhanced video microscopy, immunofluorescence confocal microscopy, and quantitative Western blotting were used to study cell shape changes and cytoskeletal dynamics in rat pancreatic acini. Amylase assays were performed to study the effect of the actin‐myosin cytoskeletal antagonists latrunculin A, BDM, and ML‐9 on secretion. We found that pancreatic acini underwent a prominent and reversible shape change in response to the physiologic secretory agonist cholecystokinin. This was accompanied by an apical activation of myosin II as well as a basolateral redistribution of both actin and myosin II. Cytoskeletal antagonists inhibited this shape change and attenuated stimulated amylase secretion. Therefore, in addition to acting as a barrier at the apex, the actin‐myosin cytoskeleton may also function to modulate cell shape to further regulate stimulated secretion. J. Cell. Physiol. 182:438–447, 2000.

Changes in kinesin distribution and phosphorylation occur during regulated secretion in pancreatic acinar cells.

In secretory cells, microtubule- (Mt-) based motor enzymes are thought to support transport of secretory vesicles to the cell surface for subsequent release. At present, the role of Mts and kinesin in secretory vesicle transport in exocrine epithelial cells has not been defined. Furthermore, it is unclear whether an agonist-induced secretory event modifies kinesin function and distribution, thus altering vesicle transport. To this end, we utilized isolated rat pancreatic acini and cultured rat pancreatic acinar cells to examine the role of Mts and kinesin in regulated secretion. Exposure of cells to cytoskeletal antagonistic drugs demonstrated that the observed movements of apically clustered zymogen granules (ZGs) are supported by Mts, but not actin. Morphological studies of Mt organization in polarized acini show that Mt plus ends extend outward from the apical membrane toward the cell center. Immunofluorescence microscopy in both cell models revealed a clear association of kinesin with apical ZGs, while quantitative immunoblot analysis of pancreatic subcellular fractions confirmed kinesin enrichment on ZG membranes. In addition, microinjection of kinesin antibodies into cultured acinar cells inhibited ZG movements. Indirect immunofluorescence staining of isolated cells and quantitative Western blotting of isolated ZGs revealed that kinesin association with granule membranes increased up to 3-fold in response to a secretory stimulus. Autoradiographic studies of 32P-labeled acini showed up to a 6-fold increase in kinesin heavy chain (KHC) phosphorylation during stimulated secretion. These studies provide the first direct evidence that Mts and kinesin support ZG movements and that physiological agonists induce a marked phosphorylation of KHC while increasing the association of kinesin with ZG membranes. These changes during agonist stimulation suggest that the participation of kinesin in zymogen secretion is regulated.

The Prevalence of Burning Mouth Syndrome: A Population-Based Study

Background Burning mouth syndrome (BMS) is defined as symptoms of persistent burning in the mouth without objective findings accounting for the symptoms.

Diffuse dermal angiomatosis of the breast: Clinicopathologic study of 5 patients

BACKGROUND Diffuse dermal angiomatosis (DDA) is a rare skin condition considered to be a type of reactive angioendotheliomatosis. Histologic features are quite characteristic. It has been reported in association with vaso-occlusive disease, trauma, or underlying hypercoagulability. In the past, it was thought to be most common on the lower extremities. OBJECTIVE The purpose of this study was to describe the clinical and histologic features of 5 patients with DDA. METHODS The clinical and histologic features of 5 patients with DDA were evaluated. RESULTS Five women (47-58 years old) had DDA of the breast. Histologic examination showed a diffuse proliferation of benign endothelial cells between the collagen bundles throughout the dermis. LIMITATIONS The main limitation of our study is the limited number of patients. CONCLUSION Involvement of the breast is much more common than previously reported. Smoking seems to be a strong risk factor for the disease. Revascularization, oral corticosteroids, and oral anticoagulation have all been reported to be somewhat successful in the treatment of DDA of the breast.

Diseases of the tongue.

The tongue is a complex organ involved in speech and expression as well as in gustation, mastication, and deglutition. The oral cavity, along with the tongue, are sites of neoplasms, reactive processes, and infections, and may be a harbinger of systemic diseases. This review includes both common and rare diseases that occur on the tongue, including: vascular and lymphatic lesions (infantile hemangiomas and oral varices), reactive and inflammatory processes (hairy tongue, pigmented fungiform papillae of the tongue, benign migratory glossitis, and fissured tongue), infections (oral hairy leukoplakia, herpes simplex and varicella-zoster virus infections, human papillomavirus, and candidiasis), premalignant lesions (leukoplakia and erythroplakia), malignant lesions (squamous cell carcinoma, Kaposi sarcoma, and lymphoproliferative diseases), and signs of systemic disease (nutritional deficiency and systemic amyloidosis).

Contact allergy in cheilitis

Recalcitrant non‐actinic cheilitis may indicate contact allergy.

Frontal fibrosing alopecia among men: A clinicopathologic study of 7 cases

Background: Frontal fibrosing alopecia (FFA) is a lichen planopilaris–variant scarring alopecia that has rarely been described in men. Objective: To characterize the clinicopathologic findings of FFA in men by studying a series of 7 male patients. Methods: We conducted a retrospective review of all cases of male patients with FFA at the Mayo Clinic from 1992 to 2016. Results: Seven male patients with FFA were identified. The frontal scalp (in 6 of 7 patients), sideburns (in 4 of 7), and temporal scalp (in 4 of 7) were most frequently involved. Three patients had involvement of the eyebrows. One patient had hair loss of the upper cutaneous lip. All patients had biopsy evidence of lichen planopilaris. None of the patients had associated autoimmune or thyroid disease. Two patients had hypogonadism upon testosterone studies. Limitations: Limitations include small sample size and varied follow‐up. Conclusions: Although most often reported among postmenopausal women, FFA also occurs among men. The clinical and histopathologic characteristics of FFA in men parallel those described in women with FFA. Unique areas of involvement in men include sideburns and facial hair. Concomitant mucocutaneous lichen planus, autoimmune disease, and thyroid disease are infrequent among men with FFA. Distribution of hair loss and associated hormonal abnormalities aid in the recognition of FFA in men.

Multiplex matrix network analysis of protein complexes in the human TCR signalosome

A multiplex antibody-mediated capture technique reveals patient-specific protein complexes. Personalized signaling complexes The response of a cell to ligands that activate cell surface receptors depends on the resulting protein-protein interactions that occur. The formation of different protein complexes leads to the activation of different intracellular signaling pathways and different cellular outputs. Thus, knowing which protein-protein interactions occur can be clinically important. To analyze these complexes in patient samples, Smith et al. devised a multiplex, antibody-based method and used it to capture complexes from T cell lysates and identify binding partners by flow cytometry. Mathematical analyses of these data enabled the construction of protein-protein interaction networks and revealed the relative abundances of particular complexes between resting and stimulated cells. Application of this technique to T cells from skin biopsies identified protein complexes that differed in their relative abundance between control donors and patients with an autoimmune skin disease. This type of analysis brings basic research a step closer to personalized therapy and may be useful as a diagnostic tool. Multiprotein complexes transduce cellular signals through extensive interaction networks, but the ability to analyze these networks in cells from small clinical biopsies is limited. To address this, we applied an adaptable multiplex matrix system to physiologically relevant signaling protein complexes isolated from a cell line or from human patient samples. Focusing on the proximal T cell receptor (TCR) signalosome, we assessed 210 pairs of PiSCES (proteins in shared complexes detected by exposed surface epitopes). Upon stimulation of Jurkat cells with superantigen-loaded antigen-presenting cells, this system produced high-dimensional data that enabled visualization of network activity. A comprehensive analysis platform generated PiSCES biosignatures by applying unsupervised hierarchical clustering, principal component analysis, an adaptive nonparametric with empirical cutoff analysis, and weighted correlation network analysis. We generated PiSCES biosignatures from 4-mm skin punch biopsies from control patients or patients with the autoimmune skin disease alopecia areata. This analysis distinguished disease patients from the controls, detected enhanced basal TCR signaling in the autoimmune patients, and identified a potential signaling network signature that may be indicative of disease. Thus, generation of PiSCES biosignatures represents an approach that can provide information about the activity of protein signaling networks in samples including low-abundance primary cells from clinical biopsies.