JCAD | The Journal of Clinical and Aesthetic Dermatology (JCAD)

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The Role of Airborne Proteins in Atopic Dermatitis

January 2010

Sarah Grim Hostetler, MD, Division of Dermatology, Ohio State University College of Medicine; Benjamin Kaffenberger, BS, The Ohio State University College of Medicine; Todd Hostetler, MD, Division of Allergy and Immunology, The Ohio State University Medical Center, Columbus, Ohio; Matthew J. Zirwas, MD, Division of Dermatology, Ohio State University College of Medicine

Abstract
Atopic dermatitis is a common, chronic skin condition. A subpopulation of patients may have cutaneous exposure to common airborne proteins exacerbating their disease through direct proteolytic activity, direct activation of proteinase-activated receptor-2 itch receptors, and immunoglobulin E binding. The most common airborne proteins significant in atopic dermatitis include house dust mites, cockroach, pet dander, and multiple pollens. The literature on atopy patch testing, skin-prick testing, and specific IgE is mixed, with greater support for the use of atopy patch test. Patients with airborne proteins contributing to their disease typically have lesions predominately on air-exposed skin surfaces including the face, neck, and arms; a history of exacerbations after exposure to airborne proteins; severe disease resistant to conventional therapies; and concurrent asthma. Treatment strategies include airborne protein avoidance, removal of airborne proteins from the skin, and barrier repair. Further research is needed to establish the benefit of allergen-specific immunotherapy.  (J Clin Aesthetic Dermatol. 2010;3(1):22–31.) Read the rest of this article »

Posted in 01-2010 (January 2010), Atopic Dermatitis, Literature Review | No Comments »

Drug-Provoked Psoriasis: Is It Drug Induced or Drug Aggravated? Understanding Pathophysiology and Clinical Relevance

January 2010

Grace K. Kim, DO, Dermatology Research Fellow, Mohave Skin & Cancer Clinics, Las Vegas, Nevada; James Q. Del Rosso, DO, Dermatology Residency Director, Valley Hospital Medical Center, Las Vegas, Nevada, and Director of Dermatology Research, Mohave Skin & Cancer Clinics, Las Vegas, Nevada

Abstract
Psoriasis is a commonly encountered dermatosis with a variety of internal and external paradoxical factors contributing to the clinical course of the disease. There are several drugs described in the literature that have been associated with the initiation, exacerbation, and aggravation of psoriasis. Understanding the pathophysiology can provide clues to treatment and management of drug-induced and drug-aggravated psoriasis, which may be indistinguishable from idiopathic psoriasis. The clinical manifestations of drug-associated psoriasis can range from plaque-type psoriasis to severe erythroderma, thus warranting astute and sustained clinical observation.
(J Clin Aesthetic Dermatol. 2010;3(1):32–38.) Read the rest of this article »

Posted in 01-2010 (January 2010), Literature Review, Psoriasis | No Comments »