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Glyphosate (N-[phosphonomethyl]glycine) is a nonselective herbicide used in agriculture as a foliage spray for the control and the destruction of herbaceous plants. Adverse skin reactions due to contact with this compound have been rarely described. We report a case of a 78-year-old woman presenting with extensive chemical bums on her trunk and legs caused by accidental contact with a glyphosate-surfactant formulation. The lesions healed in tour weeks without scarring. Key Words: Skin toxicity; Glyphosate-surfactant; Herbicide; Lesions., INTRODUCTION Glyphosate (N-[phosphonomethyl]glycine) is a frequently used pesticide in Europe and other western countries. This product is used in agriculture, forestry, and residential settings for weed control (1). Glyphosate formulations [...]

ABSTRACTBackground: The susceptibility of patients with chronic plaque psoriasis and the risks or benefits related to the use of biological therapies for COVID-19 are unknown.Few data about prevalence, clinical course and outcomes of COVID-19 among psoriatic patients were reported. The aims of this study were 1) to assess the prevalence and severity of COVID-19 in psoriatic patients treated with biologic agents during the first phase of the emergency (22 February to 22 April 2020) in Italy, and 2) to report the clinical outcomes of patients who have been exposed to individuals with confirmed SARS-CoV-2 infection.Methods: Patients with moderate-to-severe chronic plaque psoriasis, aged ≥18 years and undergoing treatment with biologic agents as of 22 February 2020, were eligible to be included in PSO-BIO-COVID study. Demographic and clinical characteristics of patients using any biologic for psoriasis treatment between 22 February and 22 April 2020 were registered.Results: A total of 12,807 psoriatic patients were included in the PSO-BIO-COVID study.In this cohort 26 patients (0.2%) had a swab confirmation of SARS-CoV-2 infection. Eleven patients required hospitalization and two died.Conclusion: The incidence of COVID-19 observed in our cohort of psoriatic patients (0.2%) is similar to that seen in the general population (0.31%) in Italy. However, the course of the disease was mild in most patients. Biological therapies may likely lessen ‘cytokine storm’ of COVID-19, which sometimes lead to multiple organ failure, ARDS, and death.

The aim of this study was a multidimensional assessment of emotion regulation strategies in order to highlight the relation between the mechanisms of emotional dysregulation and quality of life in dermatologic patients. In this context we noticed that some indicators are negatively (e.g. suppression) while others are positively related (e.g. reappraisal) with the presence of positive affects. The data analysis proved also significant differences between the patients with psoriasis and both patients with other skin conditions and healthy individuals. Thus the study suggests a possible life improvement technique based on emotional regulation enhancement.

Introduction:Immunogenicity of antitumor necrosis factor-alpha (TNFα) agents has been proven to play a significant role in the variability of clinical responses among patients with chronic inflammatory diseases. However, its clinical impact on the outcome of patients with psoriasis and psoriatic arthritis receiving anti-TNFα treatment is not yet fully clear. Despite the high rates of efficacy of anti-TNFα agents in psoriasis, a substantial proportion of patients remain who experience a primary or secondary failure or significant side effects, which are potentially ascribable to immunogenicity.Areas covered:Topics include immunologic response elicited by anti-TNFα agents, the impact of immunogenicity on treatment response to anti-TNFα and the role played by immunogenicity in the lack of efficacy of anti-TNFα agents (infliximab, adalimumab and etanercept) in psoriasis.Expert opinion:Based on data available in the literature and the clinical experience of the authors, this article suggests the optimal approach to drug monitoring and antidrug antibody assay and the most effective use of biologic immunotherapies in this setting. Immunogenicity should be taken into account in the adoption of therapeutic choices in psoriatic patients, such as anti-TNFα agent intensification, or switching to another anti-TNFα agent or a drug with a different mechanism of action.

It is well estabilished that ultraviolet radiations from sunlight are carcinogenetic for skin cells. These radiations at different wavelength induce damage in the skin manly through two mechanisms : direct DNA alteration and alteration of the immune system. The skin immune system is composed by a complex network of cells and soluble mediators that help to maintain the homeostasis of the skin. UV induced immunosuppression is mediated through different photoreceptors present in the skin that lead to either: the production of immunosuppressive cytokines such as IL-10, TNF- and TGF- or the development of suppressive T regulatory cells or to the migration in the skin of CD11 leukocytes in the skin that ultimately lead to the suppression of immune responses. The aim of this short review is to summarize the general knowledge in the field of UV-induced immunosuppression. The knowledge of the exact mechanism involved in this mechanism is important in order to develop strategies aimed at reducing skin cancer induction.

Cell migration is mediated by a group of chemotactic cytokines called chemokines: low molecular weight molecules that have been shown as important leukocyte chemical attractants to sites of inflammation and infection. Eotaxin-1, also called CCL11, was first described in 1994, as a highly specific eosino-phils chemokine. Many cell types including lymphocytes, macrophages, bronchial smooth muscle cells, endothelial cells and eosinophils, are able to produce this chemokine, predominantly after cytokine stimulation, however little is known about its expression in human skin in vivo. Eotaxin-1 also regulates the chemiotaxis and, in some conditions, activation of basophils, mast cells and T lymphocytes. Chemokine receptors are named from their ligand families, thus the CC chemokine eotaxin-1 binds to the CCR3 receptor which is expressed on eosinophis, mast cells, Th2 type lymphocytes and even on keratinocytes. It seems that eotaxin-1 is one of the most important cytokines involved in tissue inflammation playing a central role in the pathogenesis of allergic airway diseases (asthma and rhinitis), in inflammatory bowel disease and gastrointestinal allergic hypersensitivity and recently it has been proposed as a therapeutical target for these conditions. Our group has studied the role of eotaxin-1 in the pathogenesis of two skin conditions: dermatitis herpetiformis and AIDS-associated eosinophilic folliculitis, demonstrating that this chemokine, together with Th2 type cytokines (IL-13 and IL-4) is important in cell recruitment, inflammation and tissue damage; moreover eotaxin has proven to paly an important role in other skin conditions such as, bullous pemphigoid, pemphigoid gestationis, atopic dermatitis and allergic drug reactions Recent advances in the understanding of eotaxin-1-mediated mechanisms of chemotaxis in allergic and inflammatory conditions may predict that therapeutic antagonism is achievable. This paper will focus on the role that eotaxin and its receptor play in the pathogenetical mechanism in a number of dermatologic diseases, some of which, like atopic dermatitis, may benefit from the introduction of novel and more selective therapeutic options.

Background: Pemphigus vulgaris (PV) is a potentially life-threatening disease, characterized immunohistologically by IgG deposits and complement activation on the surface of keratinocytes. Complement activation has been implicated in the pathogenesis with C3deposits in about 90% of patients.Objective: In order to further elucidate the role of complement in PV and to define which cytokines play a role in C3mRNA expression, we performed an in vitro study in human keratinocytes.Methods: Normal human epidermal keratinocytes (NHuK) were incubated with PV serum and C3mRNA was measured. We previously had shown that IL-1α and TNF-α are expressed in PV in vivo and in vitro. Since cytokines are able to modulate complement activation, mRNA expression was evaluated in a similar experiment after pretreatment using antibodies against IL-1α and TNF-α.Results: Incubation of NHuK with PV sera caused their detachment from the plates after 20–30 minutes with a complete acantholysis within 12 hours. An early C3mRNA expression was seen after 30 minutes with a peak level after 1 hour. Blocking studies, using antibodies against human IL-1α and TNF-α in NHuK together with PV-IgG, showed reduction of in vitro induced acantholysis and inhibition of C3mRNA expression.Conclusions: This study supports the hypothesis that complement C3is important in PV acantholysis and that complement activation is increased by IL-1α and TNF-α.

In the epidermal compartment of skin, keratinocytes (KC), Langerhans cells (LC), and their soluble products, i.e. cytokines, constitute a unique immunologic microenvironment. KC participate in cutaneous immune responses by producing various cytokines. LC, a member of the dendritic cell (DC) family, represent the professional antigen‐presenting cells in the epidermis. Although it has been demonstrated that migration of LC from skin to lymph nodes is a critical step for the antigen presentation, molecular mechanisms for such an event remain unclear. Recent studies suggest that cytokines are able to modulate LC/DC migration. There is accumulating evidence that proinflammatory cytokines including interleukin (IL)‐1 and tumor necrosis factor a promote LC emigration from the skin, whereas the anti‐inflammatory cytokine IL‐10 is a counter‐regulator. LC/DC express chemokine receptors. Chemokines generated from lymphatic endothelial cells and lymph node cells play a role in the directional migration of LC/DC into lymph nodes. This article reviews current studies on the role of cytokines in LC/DC migration. J. Leukoc. Biol.66: 33–39; 1999.

Glyphosate Nphosphonomethylglycine is a nonselective herbicide used in agriculture as a foliage spray for the control and the destruction of herbaceous plants. Adverse skin reactions due to contact with this compound have been rarely described. We report a case of a 78yearold woman presenting with extensive chemical burns on her trunk and legs caused by accidental contact with a glyphosatesurfactant formulation. The lesions healed in four weeks without scarring.

Background: Cytomegalovirus (CMV) infection has been correlated with various autoimmune disorders. Using molecular biology techniques, DNA sequences of CMV have been reported in paraffin sections of alopecia areata (AA) lesions. Reactivation of the CMV infection has been postulated as one of the pathogenic mechanisms in AA. Other studies, using different techniques however have demonstrated no correlation between CMV and AA.Objectives: This study was to clarify the role of CMV infection and to demonstrate the absence of replication of other autoimmune diseases-related herpes virus (EBV) in the pathogenesis of AA.Methods: After extraction of mRNA from tissue samples of a patient with active patchy AA, reverse transcriptase-polymerase chain reaction was carried out using primers specific for some viral members of the β-herpes viridae family (CMV, EBV, HSV).Results: No replication of the CMV or other β-herpes viridae has been detected in any of the samples collected.Conclusions: The results strongly support the hypothesis that CMV is not the triggering factor in AA, neither as a re-activator of the immune response nor as a trigger of the autoimmunity. No other herpes virus is implicated in the pathogenesis of this disease.

Background: Direct immunofluorescence (DIF) is a necessary examination tool for the diagnosis of pemphigus. The suction-blister-method splits the skin at the lamina lucida and it is possible with a scalpel to separate the entire epidermis from the dermis.Objective: The study was to determine whether DIF is reliable on epidermal sheets separated using a suction apparatus.Methods: Thirteen patients were selected for this study: (nine with pemphigus vulgaris (PV), one with paraneoplastic pemphigus (PP), and three with pemphigus erythematosus (PE). Frozen epidermal sheets, separated from the dermis with a scalpel, were used as a substrate. Diagnosis with routine fluorescein isothiocyanate (FITC) antibodies was made.Results: In all patients a pericellular deposition of IgG was evident and in eight of these patients a pericellular deposition of C3 was present. In two cases of PE and one of PP, the C3 deposits were also present in the lower part of basal keratinocytes.Conclusion: This diagnostic method without skin biopsy is easy to perform and, together with the histology and clinical aspects, could be a useful tool in the diagnosis of pemphigus. We recommend this method when the patient is allergic to local anaesthetics, the patient easily produces hypertrophic scars, or in follow-up of already biopsied patients.