Rosalind Hughes

Hidradenitis Suppurativa Is Characterized by Dysregulation of the Th17:Treg Cell Axis, Which Is Corrected by Anti-TNF Therapy

Hidradenitis suppurativa (HS) is a chronic, inflammatory, and debilitating disease of hair follicles with 1-4% prevalence and high morbidity. There is a dearth of information on the pathogenesis and immune dysregulation underlying HS; therefore, we carried out a detailed analysis of skin-infiltrating T cells. Cells isolated from skin biopsy samples and blood from HS patients and healthy control subjects were analyzed by 16-parameter flow cytometry to provide detailed profiles of CD4 T-cell subsets. We observed substantial infiltration of inflammatory T cells with a striking T helper (Th) type 17-skewed cytokine profile in HS skin; these cells expressed the Th17 lineage marker CD161 and IL-17, as well as proinflammatory cytokines GM-CSF, IL-22, IFN-γ, and tumor necrosis factor. Regulatory T cells were also enriched in HS lesional skin; however, the ratio of Th17 to regulatory T cells was nonetheless highly dysregulated in favor of Th17 cells. In contrast, lesional skin from anti-tumor necrosis factor-treated HS patients who showed substantial clinical improvement exhibited a significant reduction in the frequency of Th17 cells and normalization of the Th17 to regulatory T cell ratio. These data suggest that inhibition of pathogenic IL-17 via tumor necrosis factor blockade is associated with improvement in immune dysregulation in HS and may provide a rationale for targeting IL-17 in the disease.

Human β-Defensin 3 and Its Mouse Ortholog Murine β-Defensin 14 Activate Langerhans Cells and Exacerbate Psoriasis-Like Skin Inflammation in Mice

Our data show that one-third of patients with PD have autoantibodies to Col XVII that also bind to THþ neurons. The lack of reactivity of PD autoantibodies with skin suggests the autoantibodies develop from neuronal Col XVII. The subset of patients with neurologic disease that develop BP likely result from epitope spreading to regions of Col XVII that are pathogenic in skin. A key question that remains is whether Col XVII autoantibodies have a detrimental effect on PD or are otherwise predictive of disease onset/outcomes. Finally, these data suggest loss of tolerance to neuronal Col XVII may contribute to the risk for pemphigoid.

Framingham risk assessment in hidradenitis suppurativa

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Adipokines are dysregulated in patients with hidradenitis suppurativa

Hidradenitis suppurativa (HS), is characterized by the appearance of painful subcutaneous nodules and dermal abscesses in the axillae, perineum and inframammary folds. The development of HS has been linked to factors such as cigarette smoking and obesity1. Patients with HS are more likely to have metabolic syndrome than control populations and develop early cardiovascular diseases2. Adipokines are signalling molecules secreted by adipose tissue and peripheral blood mononuclear cells. The expression of adipokines is dysregulated in obesity and cardiovascular diseases3. This article is protected by copyright. All rights reserved.

Rapidly Involuting Congenital Hemangioma with Pustules: Two Cases

Rapidly involuting congenital hemangiomas (RICHs) are rare tumors that usually present as well‐defined bluish or violaceous plaques or tumors with scattered telangiectasias and central or peripheral pallor. We report two previously unreported cases of RICH with associated pustules.