Background-A hallmark of Euphorbia myrsinites (EM), a member of the widespread perennial Euphorbia species, is the extrusion of a poisonous latex-like sap irritant to skin and eye after contact. The exact mechanisms underlying these effects have not been unraveled so far. Objectives-Allocation of EM sap-induced phytodermatitis to irritant or allergic contact dermatitis; investigation of mechanism(s) causing keratinocyte damage. Methods-Cutaneous effects of EM sap on healthy human skin were investigated by clinical scoring and reflectance confocal microscopy (RCM) analyses and compared to allergic contact dermatitis (ACD). In addition, the effects of sap exposure to keratinocytes were analysed in vitro using histological analyses and flow cytometry. Conclusions-We report on two cases of EM sap-induced phytodermatitis. Patch testing with fresh EM sap induced dermatitis in 100% of the tested sites with a clinical course following a decrescendo pattern. Compared to ACD the lesional phenotype was more severe and epidermal disruption more pronounced. Exposure of human skin tissues and cultivated keratinocytes to EM sap in vitro resulted in a dose-dependent increase in keratinocyte-apoptosis. The reported findings support the primarily toxic irritant nature of EM sap-induced phytodermatitis. The contribution of ingenol mebutate to (non-toxic) proinflammatory effects remains to be elucidated.
Lipoatrophia semicircularisa distinct entity? Dear Editor, Lipoatrophia semicircularis (LS) is a localized lipodystrophy of the subcutaneous fat tissue characterized by horizontal semicircular band-like depressions. 1 LS appears most frequently unilateral or bilateral on the anterior and lateral sides of the thighs. 1 In general, LS is clinically asymptomatic and the overlying skin and the underlying muscle tissue inconspicuous. The mean age of affected individuals is around 40 years with a female preponderance. 1,2 We present the case of pressure-induced LS and investigation of the histopathological changes. A 30-year-old woman in her 16th week of pregnancy presented with a 5-day history of an isolated horizontal indentation on her lateral right thigh (Fig. 1a). The overlying skin showed no signs of induration, discoloration, or inflammation. The patient denied antecedent trauma, injections, or concomitant comorbidities. However, she reported leaning against the , MD
Cathelicidins have been reported to inhibit human papillomavirus infection in vitro ; however, nothing is known about their activity in vivo . In this study, experimental skin infection with Mus musculus papillomavirus 1 resulted in robust development of cutaneous papillomas in cyclosporine A-treated C57BL/6J mice deficient for the murine cathelicidin-related antimicrobial peptide (CRAMP), in contrast to wild-type controls. Analysis of the underlying mechanisms revealed moderate disruption of virion integrity and lack of interference with viral entry and intracellular trafficking by a synthetic CRAMP peptide. Differences in the immune response to Mus musculus papillomavirus 1 infection were observed between CRAMP-deficient and wild-type mice. These included a stronger reduction in CD4+ and CD8+ T-cell numbers in infected skin, and lack of Mus musculus papillomavirus 1 -specific neutralizing antibodies in response to cyclosporine A in the absence of endogenous CRAMP. CRAMP has modest direct anti-papillomaviral effects in vitro , but exerts protective functions against Mus musculus papillomavirus 1 skin infection and disease development in vivo , primarily by modulation of cellular and humoral immunity.
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