This review summarizes recent evidence on bacterial and fungal dysbiosis in hidradenitis suppurativa (HS), focusing on how microbiome alterations influence disease pathogenesis and progression. Additionally, the role and effectiveness of antimicrobial treatments in modifying microbial communities and controlling inflammation are evaluated. Emerging studies highlight significant bacterial dysbiosis in HS lesions characterized by decreased commensal species and increased anaerobes. The presence of biofilms in chronic lesions contributes to antibiotic resistance and persistent inflammation. While fungal dysbiosis appears less pronounced, subtle alterations in the mycobiome may influence chronicity or exacerbate disease in susceptible patients. Recent research demonstrates that standard antibiotic regimens remain essential. However, biologics targeting inflammatory cytokines (e.g., TNF-α, IL-17) are increasingly used and may indirectly alter microbial communities. Microbial dysbiosis significantly influences HS pathogenesis by driving chronic inflammation and treatment resistance, especially through biofilm formation. Effective management necessitates combining antimicrobials, biologics, and surgical approaches. Future research should utilize advanced microbiome sequencing to refine targeted treatments and explore microbiome-modulating therapies as adjuncts for sustained clinical remission.

Background Pyoderma gangrenosum (PG) is a rare ulcerative skin condition with no current standardized outcomes or outcome measures. With a rich investigational therapeutic pipeline, standardization of outcomes and improvement of data quality and interpretability will promote the appropriate and consistent evaluation of potential new therapies. Core outcome sets (COS) are agreed, standardized sets of outcomes that represent the minimum that should be measured and reported in all clinical trials of a specific condition. Objectives To identify and reach a consensus on which domains (what to be measured) should be included in the Understanding Pyoderma Gangrenosum: Review and Analysis of Disease Effects (UPGRADE) core domain set for clinical trials in PG. Methods Collaborative discussions between patients and PG experts, and a systematic review of the literature identified items and prospective domains. A three-round international eDelphi exercise was performed to prioritize the domains and refine the provisional items (consensus: ≥ 70% of participants rating a domain as ‘extremely important’ and < 15% of participants voting ‘not important’), followed by an international meeting to reach consensus on the core domain set (consensus: < 30% disagreement). Item-generation discussions and consensus meetings were hosted via online videoconferences. The eDelphi exercise and consensus voting were performed using Qualtrics survey software. Participants were adults with PG, healthcare professionals, researchers and industry representatives. Results Collaborative discussions and systematic reviews yielded 115 items, which were distilled into 15 prospective domains. The eDelphi exercise removed the three lowest-priority domains (‘laboratory tests’, ‘treatment costs’ and ‘disease impact on family’) and ranked ‘pain’, ‘quality of life’ and ‘physical symptoms’ as the highest-priority prospective domains. Consensus was reached on the domains of ‘pain’, ‘quality of life’ and ‘clinical signs’. The domain of ‘disease course/disease progression’ narrowly failed to reach consensus for inclusion in the core set (32% of participants voted ‘no’). Refinement of this domain definition will be required and presented for consideration at future consensus meetings. Conclusions The UPGRADE core domain set for clinical trials in PG has been agreed by international multistakeholder consensus. Future work will develop and/or select outcome measurement instruments for these domains to establish a COS.

Dermatitis®Ahead of Print LettersAllergens and Marketing Claims of Popular Baby WashesSwetha Atluri, Charlotte Jeong, Jonathan W. Rick, Caitlyn Dagenet, Khiem A. Tran, Devea R. De, Rahul Masson, Jennifer L. Hsiao, and Vivian Y. ShiSwetha AtluriUniversity of Arizona College of Medicine Tucson, AZ USA.Cofirst author.Search for more papers by this author, Charlotte JeongCollege of Medicine University of Arkansas for Medical Sciences Little Rock, AR USA.Cofirst author.Search for more papers by this author, Jonathan W. RickDepartment of Dermatology University of Arkansas for Medical Sciences Little Rock, AR USA.Search for more papers by this author, Caitlyn DagenetUniversity of Arizona College of Medicine Tucson, AZ USA.Search for more papers by this author, Khiem A. TranDepartment of Dermatology University of Arkansas for Medical Sciences Little Rock, AR USA.Search for more papers by this author, Devea R. DeJacobs School of Medicine and Biomedical Sciences University at Buffalo Buffalo, NY USA.Search for more papers by this author, Rahul MassonKeck School of Medicine University of Southern California Los Angeles, CA USA.Search for more papers by this author, Jennifer L. HsiaoDepartment of Dermatology University of Southern California Los Angeles, CA USA.Search for more papers by this author, and Vivian Y. ShiVivian Y. Shi, MD Department of Dermatology University of Arkansas for Medical Sciences Little Rock, AR USA. E-mail Address: [email protected]https://orcid.org/0000-0002-7510-9428Department of Dermatology University of Arkansas for Medical Sciences Little Rock, AR USA.Search for more papers by this authorPublished Online:27 Oct 2023https://doi.org/10.1089/derm.2023.0175AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail View articleFiguresReferencesRelatedDetails Volume 0Issue 0 Information© 2023 American Contact Dermatitis Society. All Rights Reserved.To cite this article:Swetha Atluri, Charlotte Jeong, Jonathan W. Rick, Caitlyn Dagenet, Khiem A. Tran, Devea R. De, Rahul Masson, Jennifer L. Hsiao, and Vivian Y. Shi.Allergens and Marketing Claims of Popular Baby Washes.Dermatitis®.ahead of printhttp://doi.org/10.1089/derm.2023.0175Online Ahead of Print:October 27, 2023PDF download

Cancer-associated fibroblasts (CAFs) were presumed absent in glioblastoma given the lack of brain fibroblasts.Serial trypsinization of glioblastoma specimens yielded cells with CAF morphology and single-cell transcriptomic profiles based on their lack of copy number variations (CNVs) and elevated individual cell CAF probability scores derived from the expression of 9 CAF markers and absence of 5 markers from non-CAF stromal cells sharing features with CAFs.Cells without CNVs and with high CAF probability scores were identified in single-cell RNA-Seq of 12 patient glioblastomas.Pseudotime reconstruction revealed that immature CAFs evolved into subtypes, with mature CAFs expressing actin alpha 2, smooth muscle (ACTA2).Spatial transcriptomics from 16 patient glioblastomas confirmed CAF proximity to mesenchymal glioblastoma stem cells (GSCs), endothelial cells, and M2 macrophages.CAFs were chemotactically attracted to GSCs, and CAFs enriched GSCs.We created a resource of inferred crosstalk by mapping expression of receptors to their cognate ligands, identifying PDGF and TGF-β as mediators of GSC effects on CAFs and osteopontin and HGF as mediators of CAF-induced GSC enrichment.CAFs induced M2 macrophage polarization by producing the extra domain A (EDA) fibronectin variant that binds macrophage TLR4.Supplementing GSC-derived xenografts with CAFs enhanced in vivo tumor growth.These findings are among the first to identify glioblastoma CAFs and their GSC interactions, making them an intriguing target.

Janus kinase inhibitors (JAKis) are promising medications that the Food and Drug Administration recently approved for treatment of atopic dermatitis in January 2022. These medications offer a novel therapeutic mechanism and may be an additional treatment avenue for patients who are currently reliant on conventional immunosuppressants, such as cyclosporine A, methotrexate, or mycophenolate mofetil, or newer medications, such as dupilumab. However, redundant treatment puts patients at risk for excessive toxicity and polypharmacy, whereas abrupt tapering of a preexisting regimen may cause flares of the disease. Thus, transitioning to JAKis should be implemented strategically to retain the therapeutic benefit and minimize the risk of flares. Herein, we outline gradual transition schemas for patients needing to transition to JAKis from conventional immunosuppressants or dupilumab. There is no evidence-based guideline to instruct this transition to JAKis, and our recommendations are based on expert experience and the review of efficacy data from pivotal trials.

Supplementary Table S2 has primer sequences used to analyze expression of genes known to be expressed by GBM stem cells.

Introduction: Although hidradenitis suppurativa (HS) is associated with psychosocial comorbidities such as depression as well as modifiable comorbidities such as obesity, rates of psychosocial screening and lifestyle counseling in the USA have not been characterized. Methods: This cross-sectional study utilized publicly available data from the National Ambulatory Medical Care Survey (NAMCS) between 2008 and 2018 to identify visits with a diagnosis of HS (ICD-9 code 705.83, ICD-10 code L73.2). T tests and multivariate logistic regressions analyzed trends in rates of screening and counseling while controlling for race, sex, and age. Survey weights are applied to each visit to represent a national sample. Results: Depression screening was completed in only 2% of reported visits. No visits reported screening for alcohol misuse, substance abuse, or domestic violence. There were low rates of counseling for weight reduction (7.8%), diet and nutrition (3.3%), exercise (2.4%), smoking (1.0%), and substance abuse (0.7%). Black patients and individuals with public health insurance received less screening and counseling overall. Conclusion: Rates of psychosocial screening and counseling on lifestyle modifications are low in ambulatory clinic visits for HS patients, and there are disparities based on race and insurance status. Implementing strategies to incorporate routine psychosocial screening and lifestyle counseling into visits may improve HS patient outcomes.

<p>Supplementary Table S4 has primer sequences used to assess connexin expression</p>

Introduction: Hidradenitis suppurativa (HS) is associated with comorbidities that are risk factors for severe COVID-19 infection. We evaluated demographics and COVID-19 outcomes in HS patients. Methods: HS patients with COVID-19 (HS+/COVID+) and a randomized age-, race-, and sex-matched control population of patients without HS with COVID-19 (HS−/COVID+) were selected through a retrospective chart review. Data were collected on demographics, medications, comorbidities, vaccination status, and COVID-19 treatment/outcomes. Fisher’s exact test was used to analyze the relationship between risk factors and COVID-19 outcomes. A p value of <0.05 was considered statistically significant. Results: There were 58 HS+/COVID+ patients, primarily African American (83%, n = 48) and female (88%, n = 51). Compared to HS+/COVID+ patients, HS−/COVID+ patients were significantly more likely to have cardiovascular disease (51% vs. 24%; p = 0.0029) and be pregnant (23% vs. 4%; p = 0.0093). HS+/COVID+ and HS−/COVID+ patients did not vary significantly in vaccination rate at time of COVID-19 diagnosis (6% vs. 5%; p = 0.78). HS−/COVID+ patients were significantly more likely to have COVID-19 complications (35% vs. 7%; p = 0.001) and receive COVID-19 treatment (37% vs. 7%; p = 0.0001) when compared to HS+/COVID+ patients. Conclusion: Our findings support the growing evidence that having HS itself may not be a risk factor for severe COVID-19 outcomes.

Background: Introduction: Allergic contact dermatitis occurs in 20% of children, and contact sensitization often begins in infancy.[1] Baby washes are essential for removing dirt and irritants from skin but may contain allergens that sensitize children who have immature skin barriers. Herein, we investigate the ingredients and marketing claims of the most popular baby wash products.

To the Editor: Pediatric allergic contact dermatitis in the United States has an estimated prevalence of 16.5% in the general pediatric population, with an increased prevalence in pediatric patients with atopic dermatitis.1,2 Moisturizers are the foundation of skin care, especially in infants with immature skin barriers and increased risk of atopic dermatitis and allergic contact dermatitis; however, the contact allergens present in these products are unknown. Therefore, we aimed to investigate the allergen composition and marketing claims of the most-reviewed moisturizers targeted at babies.

<p>Supplementary Table S3 has primer sequences used to validate GBM subtype genes</p>

<p>Supplementary Table S1 describes all of the patient xenografts and samples used in this manuscript</p>

Supplementary Figures S1-S23 show some extra data including immunohistochemical stains and bar graphs that could not fit in the main text.