Diagnosing Atopic Dermatitis in Skin of Color

Adawi, Waleed; Cornman, Hannah; Kambala, Anusha; Henry, Shanae; Kwatra, Shawn G.

doi:10.1016/j.det.2023.02.003

Cited by 13 publications

(1 citation statement)

References 72 publications

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“…PN is associated with a reduction in overall quality of life and represents a significant health disparity 2,3 . Black patients are disproportionately affected by PN, and often suffer from a more severe disease presentation, and are more likely to be hospitalized for complications [4][5][6][7][8] . Despite this significant burden, PN patients are often time resistant to treatment with conventional management 9,10 .…”

Section: Main Text: Introductionmentioning

confidence: 99%

Single-cell RNA sequencing reveals dysregulated fibroblast subclusters in prurigo nodularis

Kwatra,

Patel,

Joel

et al. 2023

Preprint

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Background: Prurigo nodularis (PN) is an intensely pruritic, inflammatory skin disease with a poorly understood pathogenesis. Methods: We performed single-cell transcriptomic profiling of 28,695 lesional and non-lesional PN cells. Results: Lesional PN has increased dysregulated fibroblasts (FBs) and myofibroblasts. FBs in lesional PN were shifted towards a cancer-associated fibroblast (CAF)-like phenotype, with POSTN+WNT5A+ CAFs increased in PN, and similarly so in squamous cell carcinoma. A multi-center cohort study revealed an increased risk of SCC and CAF-associated malignancies (breast and colorectal) in PN patients. Systemic fibroproliferative diseases (renal sclerosis and idiopathic pulmonary fibrosis) were upregulated in PN patients. Ligand receptor analyses demonstrated a fibroblast neuronal axis with FB-derived WNT5A and periostin interactions with neuronal receptors MCAM and ITGAV. Compared to atopic dermatitis and psoriasis, mesenchymal dysregulation is unique to PN with an intermediate Th2/Th17 phenotype. Conclusion: These findings identify a pathogenic and targetable POSTN+WNT5A+ fibroblast subpopulation that may predispose CAF-associated malignancies in PN patients.

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