Isao Kitajima is the executive vice president, University of Toyama in Japan. He graduated from Kagoshima University School of Medicine in Japan (1982). He conducted research at The Scripps Research Institute (1990) in the USA. His research interest is in the molecular pathology of immunological disorders.
Persistent pruritus is a typical characteristic of atopic dermatitis (AD), although its etiology has not been fully elucidated. IKK2, a component of the IkB kinase complex, exerts pro-inflammatory responses, whereas its deficiency in keratinocytes paradoxically causes skin inflammation. In this study, we generated in which IKK2 is lacked in dermal fibroblasts. Nestincre;Ikk2f/f mice spontaneously developed skin inflammation limited to the face and their phenotypes are similar to those of AD patients. Moreover, these mice exhibited extensive itch behaviors such as scratching and biting as they grew up. Thus, we named Facial Atopic Dermatitis with Scratching (FADS) mice. Itch behaviors were significantly attenuated by the topical treatment with tofacitinib (Jak1/3 inhibitor) but not tacrolimus. FADS mouse is a novel animal model exhibiting severe itching. FADS will be useful in clarifying the etiology of itching accompanied with AD.
Dr. Kiticharoensak Ornrapee has completed her medical degree from Chulalongkorn University, Thailand and master’s degree of clinical dermatology from Cardiff University, UK. In addition, she earns a MBA degree from Peking University, China and did the exchange program at Waseda University, Japan. Dr. Ornrapee was a medical advisor at Novartis (Thailand). After graduating from UK, she is an aesthetitian at Hertitude clinic in Bangkok, Thailand.
Retinoids refer to all natural and synthetic products having a structure or biological activities similar to vitamin A, which helps to modulate the function of homeostasis, metabolism, epithelial growth and immune regulation as well as inflammation via retinoid receptors. Recently, there has been a growing interest in retinoids in the management of UV-related skin conditions, including skin cancer, solar ageing as well as dyspigmentation, which cause a huge dermatological and psychological burden on patients. However, scientific evidence and a standard guideline of retinoids on these conditions are still limited. Skin cancer is caused by accumulative DNA damage by UVR along with an impaired DNA repair mechanisms. Retinoids seem to have a chemopreventive effect by modulating the repair processes and programmed cell death. Acitretin appears to be effective in the chemoprevention of SCC among OTRs but due to the side effects of systemic retinoids, the application should be limited to high-risk populations and the rebound effect may occur after discontinuing medication. UVR also causes skin ageing that leads to a structural and functional deterioration of skin. Wrinkling, mottled hyperpigmentation and solar lentigo can be improved by long-term use of topical retinoids, such as topical tretinoin an adapalene. The efficacy seems to be correlated with the strength of retinoids along with their side effects, which can gradually subside overtime. Thus, low concentration of retinoids along with an emollient as well as a sunscreen application should be introduced during the initiating period to avoid drug interruption or discontinuation. Due to several limitations of clinical studies, the efficacy of cosmeceutical products on skin ageing is still controversial. Besides, long-term use of topical tretinoin may improve melasma but a treatment combination along with topical retinoids is suggested to yield a satisfactory result with minimal side effects. (OTR- Organ transplant recipient, SCC- Squamous cell carcinoma, UVR-Ultraviolet radiation)
Dr. Palki Sharma has completed her MBBS at the age of 24 years from Jammu University, India. Due to her compassion in serving the underprivileged she worked as a medical officer with Government of India for 4 years in rural parts of India. She completed her Masters in Clinical Dermatology in 2019 with a distinction from Cardiff University, School of Medicine UK.
Hidradenitis suppurative is a chronic inflammatory skin condition. It is characterized by recurrent, painful inflammatory nodules, and abscess in the intertriginous parts of the body, leading to extensive scarring and disfigurement. The exact pathogenesis of HS is unknown. However, various studies have supported the follicular occlusion theory. The primary defect in HS is believed to cause occlusion and subsequent inflammation of the pilosebaceous unit under the influence of genetic, hormonal, immune, smoking, obesity, and mechanical frictional factors. Although, it is not a life-threating skin condition, its relapsing and disfiguring nature leads to a significant impact on the patient’s quality of life. A sizeable body of research demonstrates obesity as one of the most common comorbidities associated with HS. Moreover, obesity is considered to be one of the risk factors for the development of metabolic syndrome and cardiovascular abnormalities, which are commonly associated with HS. At present, there is a lack of data on there being a direct association between HS and obesity and there is no data available showing a cause and effect relationship between weight or BMI and the disease severity. Treatment wise there is a lack of an absolute effective management modality with no definitive cure. Therapeutic studies in HS have shown a decreased efficacy of patients towards various treatment modalities, including biologics. Studies evaluating the efficacy of biologics in autoinflammatory diseases have suggested obesity to have a negative impact on anti-TNF therapy. Unfortunately, at present, there are no studies conducted on HS that can verify this theory, chiefly due to imprecise knowledge linking obesity and HS. Thus, for this paper, the scientific studies surrounding the multifaceted association between HS and obesity have been reviewed, suggesting that obesity might be a severity factor of HS. Therefore, opting a different course of treatment may help in the management of overweight and obese HS.