Anifrolumab for Adolescent Discoid Lupus Erythematosus.
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ABSTRACT:
SUBMITTER: Shaw KS
PROVIDER: S-EPMC10585408 | biostudies-literature | 2023 Oct
REPOSITORIES: biostudies-literature
Publications
Anifrolumab for Adolescent Discoid Lupus Erythematosus.
Shaw Katharina S KS Rajeh Ahmad A Le Todd T Kahn Philip J PJ Oza Vikash S VS Arkin Lisa M LM Vleugels Ruth Ann RA
JAMA network open 20231002 10
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Project description:IntroductionAlthough facial involvement in discoid lupus erythematosus (DLE) is common, eyelid involvement is atypical. Identifying this condition is challenging due to misdiagnosis, and it is essential to avoid potential deformities of the eyelid margin.Case presentationWe, herein, report the dermoscopic findings in 2 female patients with a confirmed diagnosis of DLE who presented eyelids involvement.Discussion/conclusionThis study highlights the importance of performing a dermoscopy examination to help physicians obtain an early diagnosis of DLE.
| S-EPMC9485923 | biostudies-literature
Project description:We used microarrays to explore gene expression in the skin of DLE patients
2019-01-02 | GSE120809 | GEO
Project description:ImportanceClassification criteria are the standardized definitions that are used to enroll uniform cohorts for research studies. They emphasize high specificity and are distinct from diagnostic criteria. No universally recognized classification criteria currently exist for discoid lupus erythematosus (DLE), which has led to problematic heterogeneity in observational and interventional clinical studies across the field.ObjectiveTo create and validate classification criteria for DLE using 12 previously defined candidate criteria items.Design, setting, and participantsFor this diagnostic study, candidate criteria items were prospectively applied by dermatologists and dermatopathologists at clinical visits of patients with DLE or a condition that could be confused for DLE, termed a DLE mimicker, at academic dermatology practices across the United States, Poland, Japan, and South Korea. Data were collected from December 1, 2017, to February 1, 2019, and analyzed from March 1 to September 19, 2019.Main outcomes and measuresClinical features among these 2 groups were calculated and compared with χ2 or Fisher exact tests. Candidate models were identified using best subsets logistic regression analysis. Improvement tests, fit statistics, and discrimination were considered to choose a final model.ResultsNine sites contributed 215 patients, 15 of whom had missing or incomplete data. The final model for DLE classification criteria includes only clinical variables: atrophic scarring (3 points), location in the conchal bowl (2 points), preference for the head and neck (2 points), dyspigmentation (1 point), follicular hyperkeratosis and/or plugging (1 point), and erythematous to violaceous in color (1 point), with an area under the receiving operating characteristic curve of 0.91 (95% CI, 0.87-0.95). A score of at least 5 points yields a sensitivity of 84.1% and a specificity of 75.9% in the classification of DLE, with increasing scores yielding higher specificity.Conclusions and relevanceThese findings provide the initial validation of classification criteria for DLE for use in observational and clinical trials.
| S-EPMC7301299 | biostudies-literature
Project description:Cutaneous lupus erythematosus (CLE) is a group of diseases within the spectrum of lupus that primarily manifests with skin lesions. Discoid lupus erythematosus (DLE) is the most common subtype of CLE. Currently, there is no specific medication available for the treatment of CLE. Here, we reported the efficacy and safety of upadacitinib, a JAK1 selective inhibitor, in treating one DLE patient for 28 weeks. Upadacitinib 15mg QD alone improved DLE lesions significantly, while reduction of the drug to 15mg QOD led to a relapse of the skin lesions. Upadacitinib showed favorable safety in this DLE patient in the 28-week period, except for acne, which was controlled by topical application of benzoyl peroxide gel. In this case, we observed rapid and sustained improvement of DLE lesions using upadacitinib with favorable safety, which provided the opportunity to use upadacitinib as an alternative therapy for DLE.
| S-EPMC10573460 | biostudies-literature
Project description: Not available
| S-EPMC4874325 | biostudies-literature
Project description:We performed a comparative immunology case study of client-owned dogs to determine if immune and skin gene expression profiles in spontaneous canine cutaneous lupus erythematosus mirror those observed in human cutaneous lupus.
2022-03-23 | GSE160260 | GEO
Project description:Discoid lupus erythematosus (DLE) is a common autoimmune skin disease in dogs. Conventional treatments, such as corticosteroids, can be effective but often have side effects. This case report presents a successful use of cannabinoid therapy (CT) in a dog with DLE resistant to conventional treatment. A 2-year-old mixed-breed dog with a history of DLE presented with worsening lesions despite treatment with corticosteroids and other medications. Liver enzymes levels were elevated, indicating corticosteroid-induced side effects. CT with a CBD-rich full spectrum Cannabis oil was initiated. The dosage was gradually adjusted until the minimum effective dose was found. Within a few weeks of starting CT, the dog showed significant improvement in skin lesions and in liver enzymes levels. After 1 year, the dog remains clinically stable on a low dose of full-spectrum CBD-rich oil. No evidence of DLE recurrence was observed. This case suggests that CT may be a viable alternative or complementary therapy for DLE in dogs, particularly for those experiencing adverse effects from conventional treatments. Further research is warranted to confirm the efficacy and safety of CT for DLE management in dogs.
| S-EPMC10884172 | biostudies-literature
Project description:High-risk skin cancer is a rare, but severe, complication associated with discoid lupus erythematosus (DLE). Chronic scar, inflammation, UVR, and immunosuppressive medications are proposed explanations for this heightened skin cancer risk; however, the exact mechanism driving skin carcinogenesis in DLE is unknown. The distinct co-localization of multiple independent skin cancers with areas of active inflammation in two DLE patients followed over 8 years strongly suggested that lupus inflammation promotes skin carcinogenesis in DLE. To investigate this clinical observation, we subjected lupus-prone MRL/lpr and control (MRL/n) mice to a skin carcinogenesis protocol. Skin tumors developed preferentially within the cutaneous lupus inflammation without scarring in MRL/lpr mice (P < 0.01). The inflammation in MRL/lpr skin was characterized by the accumulation of regulatory T cells, mast cells, M2 macrophages, and markedly elevated transforming growth factor-β1 and IL-6 levels, which have been linked to tumor promotion. Tacrolimus treatment reduced skin inflammation and blocked cancer development in MRL/lpr mice (P = 0.0195). A similar tumor-promoting immune environment was detected in SCCs and the perilesional skin of cancer-prone DLE patients. Therefore, discoid lupus inflammation promotes skin cancer in high-risk DLE patients, and blocking the inflammation may be critical for preventing this life-threatening complication of DLE.
| S-EPMC6309656 | biostudies-literature
Project description:Background/purposeDiscoid lupus erythematosus (DLE) serves as an interdisciplinary disease involved in dermatology and stomatology in many cases. The purpose of this study was to analyze the scientometric characteristics and research trends of DLE.Materials and methodsAll the papers on DLE were comprehensively retrieved from the Scopus database. Discipline comparison (dermatology versus others) and chronological comparison (before 2005 versus 2005-2024) were performed, so that the number of papers can be to some extent compared in the analysis.ResultsAmong all the 1239 papers on DLE, 738 (59.6 %) were published by dermatologists. Diagnosis aspect, skin manifestation, facial dermatoses, scar formation, hair loss, epiluminescence microscopy, dermoepidermal junction, arthralgia, anamnesis, young adult, Ro antibody, and dermoscopy were distinctive keywords for dermatologists; While Mouth mucosa, mouth diseases, lip neoplasms, eyelid disease, blepharitis, conjunctivitis, autoantibody, blood, neutrophil, fever, sex difference, preschool child were distinctive keywords for other scholars. Treatment response, dapsone, etretin, clobetasol, mycophenolate mofetil, glucocorticoid, triamcinolone, and drug safety were therapeutic keywords for dermatologists. Whereas quinacrine, alpha tocopherol, hydrocortisone, adverse drug reaction were therapeutic keywords for other scholars. The trend has changed to complication, disease duration, young adult, dermatitis, pruritus, antibody titer, Ro antibody, anamnesis, dermoscopy, arthralgia, dermoepidermal junction, keratosis, and African American, drug withdrawal, tacrolimus, mycophenolate mofetil, etretin, clobetasol, cyclophosphamide, and drug safety after 2005.ConclusionThis scientometric study elucidated the current scenario and research trends of DLE, and would help in improving in reciprocal collaboration and communication for investigations on this disease.
| S-EPMC11763223 | biostudies-literature
Project description:BackgroundB-cell activating factor of the TNF family (BAFF) promotes the maturation and survival of B cells. Because BAFF levels are elevated in systemic lupus erythematosus (SLE) patients, BAFF has been the target of emerging therapies for SLE, such as belimumab. Levels of BAFF and its receptors in discoid lupus erythematosus (DLE) patients are unknown.ObjectiveTo compare skin and blood mRNA and protein levels of BAFF and its receptors BAFF-R, TACI, and BCMA in DLE subjects with (DLE+/SLE+ (N=28)) and without SLE (DLE+/SLE- (N=35)), psoriasis subjects (N=11), and normal subjects (N=42).MethodsWe used quantitative real-time PCR to measure blood and skin BAFF, BAFF-R, TACI, and BCMA mRNA, sandwich ELISAs to measure sera BAFF, and immunohistochemistry to evaluate BAFF and BAFF-R skin protein expression.ResultsBAFF mRNA and protein levels were highest in DLE+/SLE+blood, followed by DLE+/SLE-, psoriasis, and normal blood. BAFF protein also correlated with anti-nuclear antibodies, and autoantibodies against double-stranded DNA, single-stranded DNA, and ribonucleoprotein, and Systemic Lupus Erythematosus Disease Activity Index scores in DLE patients. While showing no difference between DLE+/SLE+ and DLE+/SLE- skin, BAFF and its receptors mRNA were up-regulated in DLE skin vs. normal and psoriasis skin. DLE skin had higher percentages of BAFF-R⁺ inflammatory cells, likely T cells and macrophages, than psoriasis and normal skin.ConclusionsBAFF may be a serologic marker of systemic disease in DLE patients. BAFF and its receptors are elevated in DLE skin, suggesting that targeted therapies against these proteins could treat refractory DLE patients.
| S-EPMC3946198 | biostudies-literature