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| EDITORIAL |
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| Year : 2022 | Volume
: 40
| Issue : 4 | Page : 195-196 |
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Recent developments in our understanding of autoinflammatory keratinization diseases
Stephen Chu-Sung Hu
Department of Dermatology, Kaohsiung Medical University Hospital; Department of Dermatology, College of Medicine, Kaohsiung Medical University; Department of Dermatology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| Date of Submission | 08-Dec-2022 |
| Date of Acceptance | 08-Dec-2022 |
| Date of Web Publication | 27-Dec-2022 |
Correspondence Address:
Dr. Stephen Chu-Sung Hu
Department of Dermatology, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung 807
Taiwan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/1027-8117.365589
How to cite this article:
Hu SC. Recent developments in our understanding of autoinflammatory keratinization diseases. Dermatol Sin 2022;40:195-6 |
Autoinflammatory keratinization disease (AiKD) is an emerging disease concept and is a group of keratinizing skin conditions characterized by increased activation of the innate immune system.[1] These diseases include generalized pustular psoriasis,[2],[3] pityriasis rubra pilaris,[4] hidradenitis suppurativa,[5] and porokeratosis.[6] Recently, the underlying etiologies and molecular mechanisms associated with the development of AiKDs have been gradually elucidated. In this issue of Dermatologica Sinica, a comprehensive review by Akiyama described the clinical features and pathogenesis of various AiKDs.[7] In particular, recent advances in elucidation of underlying signaling pathways and novel treatment strategies were emphasized. It is expected that more skin disorders will be included as AiKDs in the near future, and our increasing understanding regarding their pathogenic mechanisms will lead to the development of new therapeutic modalities.
This issue of Dermatologica Sinica
Recently, with increasing emphasis on the application of evidence-based medicine in clinical practice, there has been a growing number of publications based on systemic reviews and meta-analyses. In order to improve the quality of systemic reviews, various international guidelines have been established in the research community.[8] In this issue, Kuo et al. described the essential steps involved in performing a high-quality systemic review.[9] Understanding these important steps will ensure the quality of systemic reviews and enable the provision of current best evidence for clinical decision-making.
Alopecia areata is a common autoimmune disease characterized by circular patches of hair loss on the scalp and other body regions. Huang and Tsai used a retrospective approach to investigate the therapeutic effect of diphenylcyclopropenone (a topical contact allergen) for alopecia areata in a Taiwanese medical center. They found that topical diphenylcyclopropenone is an effective form of treatment for alopecia areata, with >90% sustainable hair regrowth in 32.6% (28 out of 86) of patients.[10] However, possible side effects associated with this topical treatment modality should be monitored.
Extramammary Paget's disease is a malignant skin condition with high recurrence rate and poor prognosis.[11],[12] In this issue of Dermatologica Sinica, Hou et al. performed a retrospective study to investigate the clinical and pathological characteristics of perianal Paget's disease in a Taiwanese medical center.[13] They found that out of 8 patients with perianal Paget's disease, four cases were associated with underlying rectal or anal adenocarcinoma (secondary extramammary Paget's disease). In addition, they found differential expression of CK7 in the epidermal and dermal cancer cells for two cases with secondary perianal Paget's disease. These findings may have implications for the diagnosis of this skin malignancy.
Recently, COVID-19 vaccines have been administered to the worldwide population. However, there have been reports of cutaneous side effects following vaccination in a minority of people.[14],[15] These adverse effects include new onset or exacerbation of urticaria,[16] psoriasis,[17] atopic dermatitis,[18] and lupus erythematosus.[19] In this issue, Chao and Liu described a patient who developed bullous pemphigoid following AstraZeneca COVID-19 vaccination.[20] Therefore, dermatologists should be aware of the possibility of various immune-mediated cutaneous diseases which may occur following the administration of COVID-19 vaccines.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Akiyama M, Takeichi T, McGrath JA, Sugiura K. Autoinflammatory keratinization diseases: An emerging concept encompassing various inflammatory keratinization disorders of the skin. J Dermatol Sci 2018;90:105-11.  |
| 2. | Takeichi T, Akiyama M. Generalized pustular psoriasis: Clinical management and update on autoinflammatory aspects. Am J Clin Dermatol 2020;21:227-36. |
| 3. | Akiyama M. Pustular psoriasis as an autoinflammatory keratinization disease (AiKD): Genetic predisposing factors and promising therapeutic targets. J Dermatol Sci 2022;105:11-7. |
| 4. | Akiyama M, Takeichi T, McGrath JA, Sugiura K. Autoinflammatory keratinization diseases. J Allergy Clin Immunol 2017;140:1545-7. |
| 5. | Frew JW. Hidradenitis suppurativa is an autoinflammatory keratinization disease: A review of the clinical, histologic, and molecular evidence. JAAD Int 2020;1:62-72. |
| 6. | Takeichi T, Akiyama M. Familial or sporadic porokeratosis as an autoinflammatory keratinization disease. J Dermatol 2019;46:e125-6. |
| 7. | Akiyama M. Autoinflammatory keratinization diseases: The concept, diseases involved, and pathogeneses. Dermatol Sin 2022;40:197-203. [Full text] |
| 8. | Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021;372:n71. |
| 9. | Kuo LT, Shao SC, Chi CC. Ten essential steps for performing a systematic review: A quick tutorial. Dermatol Sin 2022;40:204-6. [Full text] |
| 10. | Huang CM, Tsai TF. Topical diphenylcyclopropenone in the treatment of alopecia areata: A 10-year follow-up of 86 cases in a single center. Dermatol Sin 2022;40:214-21. [Full text] |
| 11. | Ishizuki S, Nakamura Y. Extramammary Paget's disease: Diagnosis, pathogenesis, and treatment with focus on recent developments. Curr Oncol 2021;28:2969-86. |
| 12. | Merritt BG, Degesys CA, Brodland DG. Extramammary Paget disease. Dermatol Clin 2019;37:261-7. |
| 13. | Hou PC, Lee CN, Wong TW, Hsu TC, Wu CL, Lee JY. A clinicopathological study of perianal Paget disease: A single center-based cohort study and literature review. Dermatol Sin 2022;40:222-30. [Full text] |
| 14. | Gambichler T, Boms S, Susok L, Dickel H, Finis C, Abu Rached N, et al. Cutaneous findings following COVID-19 vaccination: Review of world literature and own experience. J Eur Acad Dermatol Venereol 2022;36:172-80. |
| 15. | Bellinato F, Maurelli M, Gisondi P, Girolomoni G. Cutaneous adverse reactions associated with SARS-CoV-2 vaccines. J Clin Med 2021;10:5344. |
| 16. | Anvari S, Samarakoon U, Fu X, Jaggers J, Gonzalez-Estrada A, Chong HJ, et al. Urticaria and/or angioedema secondary to mRNA COVID-19 vaccines: Updates from a United States case registry. Allergy 2022;10.1111/all.15447. [doi: 10.1111/all.15447]. |
| 17. | Krajewski PK, Matusiak Ł, Szepietowski JC. Psoriasis flare-up associated with second dose of Pfizer-BioNTech BNT16B2b2 COVID-19 mRNA vaccine. J Eur Acad Dermatol Venereol 2021;35:e632-4. |
| 18. | Potestio L, Napolitano M, Bennardo L, Fabbrocini G, Patruno C. Atopic dermatitis exacerbation after Covid-19 vaccination in Dupilumab-treated patients. J Eur Acad Dermatol Venereol 2022;36:e409-11. |
| 19. | Kreuter A, Licciardi-Fernandez MJ, Burmann SN, Burkert B, Oellig F, Michalowitz AL. Induction and exacerbation of subacute cutaneous lupus erythematosus following mRNA-based or adenoviral vector-based SARS-CoV-2 vaccination. Clin Exp Dermatol 2022;47:161-3. |
| 20. | Chao YC, Liu KL. New-onset bullous pemphigoid triggered by AstraZeneca COVID-19 vaccine. Dermatol Sin 2022;40:245-6. [Full text] |
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