Itch in dermatomyositis: the role of increased skin interleukin-31

Abstract

Increased skin IL-31 may play a role in DM-associated itch, and ongoing trials will evaluate the effects of systemic treatment on IL-31 and itch in DM.

Advances in Cutaneous Lupus Erythematosus and Dermatomyositis: A Report from the 4th International Conference on Cutaneous Lupus Erythematosus—An Ongoing Need for International Consensus and Collaborations

“…Pruritus is a significant deterrent to the quality of life of DM patients, with 50% of them having moderate to severe itch (Kim et al, 2018). Dr. Hee Joo Kim (Gachon University College of Medicine, Incheon, Korea) has worked with the research team from the Autoimmune Skin Diseases Unit at the University of Pennsylvania to show that IL-31 in the skin may play a role in DM-associated itch (Kim et al, 2018). She showed that in DM patients experiencing itch, gene expression of IL-31 and IL-31 receptor A in the lesional skin was up-regulated compared with nonlesional skin and skin from healthy control individuals.…”

“…He concluded that being definitive about causality is challenging, although there are data that show that specific environmental triggers such as UV light, urban pollution, small particulate exposure, and infectious agents such as parvovirus B19 and paramyxovirus (especially in juvenile DM) may play a role. He also highlighted the findings of a recent study on the effects of a certain herbbased weight loss supplements on the induction of TNF-a, IFN-a, and IFN-b from immune cells of DM patients in vitro (Zeidi et al, 2018). This investigation was initiated after a series of patients clinically presented with DM shortly after ingesting the weight loss powder.…”

New therapeutics for itch in dermatomyositis

“…Kim et al . 's study of the efficacy of lenabasum (a nonpsychoactive cannabinoid derivative) in downregulating interleukin (IL)‐31 and pruritus in dermatomyositis (DM) confirms IL‐31 as an important mediator of pruritus in DM, similar to its established role in atopic dermatitis and cutaneous T‐cell lymphoma . The effect of IL‐31 suppression resulting in IL‐4 reduction in lesional DM skin suggests a role for this therapy in suppressing the inflammatory component of DM in addition to its effect upon pruritus .…”

“…Studies such as Kim et al . 's would not have been possible without the past two decades of translational work in psoriasis . Now the focus is shifting to how the skills gained and lessons learnt can be applied in the identification and development of new targeted therapies for other inflammatory dermatoses.…”

“…The science from translational work such as Kim et al . 's is novel and exciting with the potential for alleviating significant morbidity. However, we must tread carefully and methodically, relying on high‐quality evidence to support approaches to patient care.…”