New Advancements in Chronic Inflammatory Skin Disease

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Immunology and Immunotherapy".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 25901

Special Issue Editors


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Guest Editor
Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy
Interests: inflammatory autoimmune disease

E-Mail Website
Guest Editor
Department of Health Sciences, Section of Dermatology, University of Florence School of Medicine, Florence, Italy
Interests: chronic inflammatory skin disease; differentiation; dendritic cells; biologics; molecular targets
Department of Health Sciences, Section of Dermatology, University of Florence School of Medicine, Florence, Italy
Interests: chronic inflammatory skin disease; differentiation; dendritic cells; biologics; molecular targets

Special Issue Information

Dear Colleagues,

Chronic inflammatory skin diseases represent a great proportion of skin diseases, and the therapy in daily life is challenging. Most of these diseases (e.g., psoriasis, atopic dermatitis, hidradenitis suppurativa) are characterized by undertreatment and/or a great delay in correct diagnosis and proper treatment. Therefore, the quality of life of these patients is very poor.

The great improvement in the pathogenesis knowledge of these diseases has allowed clinicians to better provide tailored treatment according to the main subsets of each specific chronic inflammatory skin disease.

In recent years, many new biologics and small molecules have been introduced for the treatment of chronic inflammatory skin diseases, substantially changing the clinical profile of patients and in some cases avoiding the progression of the underlying disease. In some instances, to the great success of the clinical outcomes the quality of life has also improved as a consequence. On the other hand, as is the case with hidradenitis suppurativa, not all these efforts in research and development resulted in effective therapies. Understanding triggers may be crucial to increasing therapeutic effectiveness and preventing the exacerbation of these chronic conditions. Furthermore, to date, there has been little progress in the study of “special patient populations” (e.g., pediatric, obstetric, and geriatric patients). Suffice it to say that, until recently, little attention was paid to gender differences in treatment outcomes among patients with chronic inflammatory skin diseases.

The Special Issue entitled "New Advancements in Chronic Inflammatory Skin Disease” is now open for submissions, welcoming papers which aim to bring together the most relevant scientific research on chronic inflammatory skin diseases, focusing on mechanism, pathophysiology, and recent or emerging advancements in therapy.

Prof. Dr. Francesca Prignano
Dr. Antonella Di Cesare
Dr. Elia Rosi
Guest Editors

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Keywords

  • chronic inflammatory skin disease (CISD)
  • biologics
  • psoriasis
  • atopic Dermatitis
  • hidradenitis suppurativa
  • therapy of CISD
  • gender in CISD
  • pathogenesis of CISD

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Published Papers (7 papers)

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Research

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12 pages, 2552 KiB  
Article
New Data on the Features of Skin Barrier in Hidradenitis Suppurativa
by Orsolya Somogyi, Zsolt Dajnoki, Lilla Szabó, Krisztián Gáspár, Zoltán Hendrik, Christos C. Zouboulis, Klaudia Dócs, Péter Szücs, Katalin Dull, Dániel Törőcsik, Anikó Kapitány and Andrea Szegedi
Biomedicines 2023, 11(1), 127; https://doi.org/10.3390/biomedicines11010127 - 4 Jan 2023
Cited by 3 | Viewed by 2262
Abstract
Hidradenitis suppurativa (HS) is a Th1/17-driven inflammatory skin disease of the apocrine gland-rich (AGR) skin regions, where keratinocytes seem to be the crucial drivers of the initial pathogenic steps. However, the possible role of permeability barrier alteration in activating keratinocytes during HS development [...] Read more.
Hidradenitis suppurativa (HS) is a Th1/17-driven inflammatory skin disease of the apocrine gland-rich (AGR) skin regions, where keratinocytes seem to be the crucial drivers of the initial pathogenic steps. However, the possible role of permeability barrier alteration in activating keratinocytes during HS development has not been clarified. We compared the major permeability barrier elements of non-lesional HS (HS-NL; n = 10) and lesional HS (HS-L; n = 10) skin with healthy AGR regions (n = 10) via RT-qPCR and immunohistochemistry. Stratum corneum components related to cornified envelope formation, corneocyte desquamation and (corneo)desmosome organization were analyzed along with tight junction molecules and barrier alarmins. The permeability barrier function was also investigated with transepidermal water loss (TEWL) measurements (n = 16). Junction structures were also visualized using confocal microscopy. At the gene level, none of the investigated molecules were significantly altered in HS-NL skin, while 11 molecules changed significantly in HS-L skin versus control. At the protein level, the investigated molecules were similarly expressed in HS-NL and AGR skin. In HS-L skin, only slight changes were detected; however, differences did not show a unidirectional alteration, as KRT1 and KLK5 were detected in decreased levels, and KLK7, KRT6 and DSG1 in increased levels. No significant differences in TEWL or the expression of junction structures were assessed. Our findings suggest that the permeability barrier is not significantly damaged in HS skin and permeability barrier alterations are not the driver factors of keratinocyte activation in this disease. Full article
(This article belongs to the Special Issue New Advancements in Chronic Inflammatory Skin Disease)
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15 pages, 5215 KiB  
Article
Effect of Melatonin on Psoriatic Phenotype in Human Reconstructed Skin Model
by Sarah Adriana Scuderi, Laura Cucinotta, Alessia Filippone, Marika Lanza, Michela Campolo, Irene Paterniti and Emanuela Esposito
Biomedicines 2022, 10(4), 752; https://doi.org/10.3390/biomedicines10040752 - 23 Mar 2022
Cited by 7 | Viewed by 2930
Abstract
Psoriasis is an inflammatory and auto-immune skin-disease characterized by uncontrolled keratinocyte proliferation. Its pathogenesis is not still fully understood; however, an aberrant and excessive inflammatory and immune response can contribute to its progression. Recently, more attention has been given to the anti-inflammatory and [...] Read more.
Psoriasis is an inflammatory and auto-immune skin-disease characterized by uncontrolled keratinocyte proliferation. Its pathogenesis is not still fully understood; however, an aberrant and excessive inflammatory and immune response can contribute to its progression. Recently, more attention has been given to the anti-inflammatory and immunomodulators effects of melatonin in inflammatory diseases. The aim of this paper was to investigate the effect of melatonin on psoriatic phenotype and also in S. aureus infection-associated psoriasis, with an in vitro model using Skinethic Reconstructed Human Epidermis (RHE). An in vitro model was constructed using the RHE, a three-dimensional-model obtained from human primary-keratinocytes. RHE-cells were exposed to a mix of pro-inflammatory cytokines, to induce a psoriatic phenotype; cells were also infected with S. aureus to aggravate psoriasis disease, and then were treated with melatonin at the concentrations of 1 nM, 10 nM, and 50 nM. Our results demonstrated that melatonin at higher concentrations significantly reduced histological damage, compared to the cytokine and S. aureus groups. Additionally, the treatment with melatonin restored tight-junction expression and reduced pro-inflammatory cytokine levels, such as interleukin-1β and interleukin-12. Our results suggest that melatonin could be considered a promising strategy for psoriasis-like skin inflammation, as well as complications of psoriasis, such as S. aureus infection. Full article
(This article belongs to the Special Issue New Advancements in Chronic Inflammatory Skin Disease)
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Review

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19 pages, 1312 KiB  
Review
Hidradenitis Suppurativa: The Influence of Gender, the Importance of Trigger Factors and the Implications for Patient Habits
by Elia Rosi, Maria Thais Fastame, Gianmarco Silvi, Prisca Guerra, Giulia Nunziati, Antonella Di Cesare, Ilaria Scandagli, Federica Ricceri and Francesca Prignano
Biomedicines 2022, 10(11), 2973; https://doi.org/10.3390/biomedicines10112973 - 18 Nov 2022
Cited by 5 | Viewed by 4410
Abstract
Hidradenitis suppurativa (HS) is a debilitating, chronic, inflammatory skin disease primarily affecting apocrine gland-rich areas of the body. On the one hand, the presence of triggering factors—some identified, others only hypothesized—may initiate or perpetuate the pathogenic process of HS. In addition to cigarette [...] Read more.
Hidradenitis suppurativa (HS) is a debilitating, chronic, inflammatory skin disease primarily affecting apocrine gland-rich areas of the body. On the one hand, the presence of triggering factors—some identified, others only hypothesized—may initiate or perpetuate the pathogenic process of HS. In addition to cigarette smoking and diet, other trigger factors, including choice of clothing, are frequently observed in clinical practice. On the other hand, the presence of disease may influence habits of HS patients. Indeed, high incidences of sexual and sleep impairment have been reported in these patients. Consequently, alcohol and substance abuse may be a coping strategy for the emotional and psychological disease burden. Furthermore, a greater awareness of gender differences in HS may be important for dermatologists in their own clinical practice (i.e., pregnancy and breastfeeding). Consequently, in this loop interaction, comprehensive knowledge of all factors involved is crucial for the management of HS patients. Thus, the objective of this review is to (i) discuss the influence of gender on HS, (ii) summarize the most frequent triggering factors of HS and (iii) analyze the impact of HS on patient habits. Full article
(This article belongs to the Special Issue New Advancements in Chronic Inflammatory Skin Disease)
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13 pages, 295 KiB  
Review
Atopic Dermatitis: Clinical Aspects and Unmet Needs
by Fabio Lobefaro, Giulio Gualdi, Sergio Di Nuzzo and Paolo Amerio
Biomedicines 2022, 10(11), 2927; https://doi.org/10.3390/biomedicines10112927 - 14 Nov 2022
Cited by 9 | Viewed by 4327
Abstract
Atopic dermatitis is a common chronic-relapsing, inflammatory and itchy eczematous skin disorder which occurs in both children and adults. AD pathogenesis is complex and several factors are implicated. Pruritus plays a pivotal role in disease’s burden, significantly worsening atopic patient quality of life [...] Read more.
Atopic dermatitis is a common chronic-relapsing, inflammatory and itchy eczematous skin disorder which occurs in both children and adults. AD pathogenesis is complex and several factors are implicated. Pruritus plays a pivotal role in disease’s burden, significantly worsening atopic patient quality of life by limiting productivity and daily activities. AD diagnosis relies still on the experience of the healthcare professional and there are several unmet needs as for the diagnostic criteria, the management and the recognition of the burden of the disease. In this paper we present an indeep focus on the main clinical features of AD and the major unmet needs that should be addressed in the next research. Full article
(This article belongs to the Special Issue New Advancements in Chronic Inflammatory Skin Disease)
14 pages, 332 KiB  
Review
Therapy of PsO in Special Subsets of Patients
by Antonella Di Cesare, Federica Ricceri, Elia Rosi, Maria Thais Fastame and Francesca Prignano
Biomedicines 2022, 10(11), 2879; https://doi.org/10.3390/biomedicines10112879 - 10 Nov 2022
Cited by 4 | Viewed by 1780
Abstract
Psoriasis is a chronic, inflammatory skin disease that may occur at any age, with a bimodal peak of incidence around the age of 16–20 years of age (early onset) and 57–60 years (late-onset). It is estimated that roughly 70% of patients develop the [...] Read more.
Psoriasis is a chronic, inflammatory skin disease that may occur at any age, with a bimodal peak of incidence around the age of 16–20 years of age (early onset) and 57–60 years (late-onset). It is estimated that roughly 70% of patients develop the disease before the age of 40, which coincides with the reproductive years. Moreover, psoriasis is a chronic disease, meaning that, with increased life-duration expectancy, the number of patients affected with psoriasis aged over 65 years is going to increase and represent a big therapeutic challenge. Actually, no specific drug recommendation is available, based only on the age of the patients, while therapeutic prescription should take into account that elderly patients have more comorbidities than younger patients, with polypharmacy and an increased risk of drug interactions. Women with psoriasis are more likely to report a worse influence of the disease on their quality of life, and they are more susceptible to the development of depression. Furthermore, pregnancy and lactation represent a major contraindication to several systemic agents, and only a few studies exist providing the safety of certain drugs during these periods of life of a woman, such as certolizumab pegol. In this paper, we discuss systemic therapeutic strategies, including conventional and biological therapies, in a special subset of patients affected with moderate-to-severe psoriasis focusing on elderly patients and on female patients in fertile age, pregnancy, and lactation. Full article
(This article belongs to the Special Issue New Advancements in Chronic Inflammatory Skin Disease)
21 pages, 1541 KiB  
Review
Regenerative Medicine-Based Treatment for Vitiligo: An Overview
by Barbara Bellei, Federica Papaccio and Mauro Picardo
Biomedicines 2022, 10(11), 2744; https://doi.org/10.3390/biomedicines10112744 - 28 Oct 2022
Cited by 3 | Viewed by 6400
Abstract
Vitiligo is a complex disorder with an important effect on the self-esteem and social life of patients. It is the commonest acquired depigmentation disorder characterized by the development of white macules resulting from the selective loss of epidermal melanocytes. The pathophysiology is complex [...] Read more.
Vitiligo is a complex disorder with an important effect on the self-esteem and social life of patients. It is the commonest acquired depigmentation disorder characterized by the development of white macules resulting from the selective loss of epidermal melanocytes. The pathophysiology is complex and involves genetic predisposition, environmental factors, oxidative stress, intrinsic metabolic dysfunctions, and abnormal inflammatory/immune responses. Although several therapeutic options have been proposed to stabilize the disease by stopping the depigmentation process and inducing durable repigmentation, no specific cure has yet been defined, and the long-term persistence of repigmentation is unpredictable. Recently, due to the progressive loss of functional melanocytes associated with failure to spontaneously recover pigmentation, several different cell-based and cell-free regenerative approaches have been suggested to treat vitiligo. This review gives an overview of clinical and preclinical evidence for innovative regenerative approaches for vitiligo patients. Full article
(This article belongs to the Special Issue New Advancements in Chronic Inflammatory Skin Disease)
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Other

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28 pages, 945 KiB  
Systematic Review
A Systematic Review of Atopic Dermatitis: The Intriguing Journey Starting from Physiopathology to Treatment, from Laboratory Bench to Bedside
by Giulia Radi, Anna Campanti, Federico Diotallevi, Emanuela Martina, Andrea Marani and Annamaria Offidani
Biomedicines 2022, 10(11), 2700; https://doi.org/10.3390/biomedicines10112700 - 25 Oct 2022
Cited by 11 | Viewed by 2670
Abstract
Atopic dermatitis (AD) is a common chronic inflammatory and immune-mediated skin disease with a complex pathophysiology and still represents a therapeutic challenge, owing to limited responses to available treatments. However, recent advances in the understanding of AD pathophysiology have led to the discovery [...] Read more.
Atopic dermatitis (AD) is a common chronic inflammatory and immune-mediated skin disease with a complex pathophysiology and still represents a therapeutic challenge, owing to limited responses to available treatments. However, recent advances in the understanding of AD pathophysiology have led to the discovery of several new potential therapeutic targets, and research in the field of new molecules with therapeutic perspectives is boiling, with more than 70 new promising drugs in development. The aim of this systematic review is to provide the state of the art on the current knowledge concerning the pathophysiology of the disease and on novel agents currently being investigated for AD, and to highlight which type of evolution is going to take place in therapeutic approaches of atopic dermatitis in the coming years. Full article
(This article belongs to the Special Issue New Advancements in Chronic Inflammatory Skin Disease)
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