Follicular psoriasis: an underdiagnosed entity?

Souza, Bruno de Castro e; Bandeira, Luisa Groba; Cunha, Thais do Amaral Carneiro; Valente, Neusa Yuriko Sakai

doi:10.1590/abd1806-4841.20197987

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…Down-regulation of hair follicle genes (Supplementary Table 1f) is perhaps consistent with hair follicles being located next to areas of subcutaneous edema (Figure 3B, Supplementary Figure 7A) and adjacent to neutrophil infiltrates (Figure 3D, bottom left) (Supplementary Figure 7B). The presence of neutrophils in the epidermis or in the hair follicles, as has been described for psoriasis (123, 124), was not observed in our studies.…”

Section: Resultssupporting

confidence: 50%

“…Perhaps the most compelling bioinformatics support (for a fiber-mediated increase in pro-inflammatory and IL-17-mediated immunopathology after CHIKV infection) comes from the significant similarities between CHIKV arthritis in mice fed a high fiber diet and mouse models of inflammatory psoriasis (122) (Figure 4B). Although this was an unexpected and novel finding, there are salient parallels between CHIKV infection and psoriasis; (i) CHIKV after a high fiber diet and psoriasis both involve neutrophil recruitment (148), (ii) psoriasis can cause alopecia (149), and can have follicular involvement (124), with alopecia frequently reported by CHIKV patients (150–153) and also seen in some CHIKV mouse models (154, 155), (iii) although distinct from psoriatic lesions, skin manifestations (usually maculopapular rashes) are well-described for arthritogenic alphavirus infections in humans, but are rarely overt in mouse models, although they can be detected by IHC in certain settings (156), and (iv) perhaps most cogent, both psoriasis and CHIKV are associated with arthritis (157). The changes in skin immunopathology seen herein are consistent with the well-described ability of the gut microbiome to influence immunity in the skin via the so-called gut-skin-axis (158).…”

Section: Discussionmentioning

confidence: 92%

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Exacerbation of Chikungunya Virus Rheumatic Immunopathology by a High Fiber Diet and Butyrate

et al. 2019

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Chikungunya virus (CHIKV) is a mosquito transmitted alphavirus associated with a robust systemic infection and an acute inflammatory rheumatic disease. A high fiber diet has been widely promoted for its ability to ameliorate inflammatory diseases. Fiber is fermented in the gut into short chain fatty acids such as acetate, propionate, and butyrate, which enter the circulation providing systemic anti-inflammatory activities. Herein we show that mice fed a high fiber diet show a clear exacerbation of CHIKV arthropathy, with increased edema and neutrophil infiltrates. RNA-Seq analyses illustrated that a high fiber diet, in this setting, promoted a range of pro-neutrophil responses including Th17/IL-17. Gene Set Enrichment Analyses demonstrated significant similarities with mouse models of inflammatory psoriasis and significant depression of macrophage resolution phase signatures in the CHIKV arthritic lesions from mice fed a high fiber diet. Supplementation of the drinking water with butyrate also increased edema after CHIKV infection. However, the mechanisms involved were different, with modulation of AP-1 and NF-κB responses identified, potentially implicating deoptimization of endothelial barrier repair. Thus, neither fiber nor short chain fatty acids provided benefits in this acute infectious disease setting, which is characterized by widespread viral cytopathic effects and a need for tissue repair.

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Section: Resultssupporting

confidence: 50%

Section: Discussionmentioning

confidence: 92%

Exacerbation of Chikungunya Virus Rheumatic Immunopathology by a High Fiber Diet and Butyrate

et al. 2019

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“…In adults, it presents as multiple, discrete and follicular hyperkeratotic papules predominantly, and in children as asymmetric, grouped, follicular and keratotic papules predominantly affecting the trunk, axilla and extensor aspects of limbs and resembling PRP [ Figure 8a ]. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

A Study of Clinical, Dermoscopic and Histopathological Correlation in Follicular Keratotic Diseases

Gangadhar

Adya

Inamadar

2021

Indian Dermatology Online Journal

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Context: Follicular keratotic disorder is an abnormal keratinization affecting the follicular orifices and clinically characterized by hyperkeratotic follicular papules affecting various sites. Dermoscopy is a non-invasive diagnostic tool and differentiates closely resembling diseases as well as possibly prevents need for an invasive biopsy. Aim: This study was aimed to find the correlation between clinical, dermoscopic and histopathological findings in follicular keratotic diseases and to establish the dermoscopic criteria in the diagnosis of primary follicular keratotic diseases. Materials and Methods: This was a hospital-based prospective cross-sectional study of 30 consecutive patients clinically diagnosed with follicular keratotic diseases, irrespective of age and duration of the disease. Results: The study consisted of 30 patients with a mean age of 19.57 ± 9.69 years. The most common primary follicular keratotic disease observed was phrynoderma and secondary follicular keratotic disease was follicular lichen planus (lichen planopilaris). The predominant dermoscopic finding among all the follicular keratotic diseases was perifollicular scaling 29 (96.7%) followed by keratotic plug 28 (93.3%). The most common histopathological feature was dilated follicular infundibulum 22 (73.3%) followed by follicular plug 15 (50%) and dermal perivascular infiltration 22 (73.3%). The clinical and dermoscopic features showed a significant statistical association with the histopathological findings. Conclusion: Dermoscopy is a simple, non-invasive diagnostic tool that helps in differentiating and diagnosing the closely resembling follicular keratotic diseases.

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“…In psoriatic alopecia, there are some specific pathological changes in HFs. 10 The pathological changes include increasing proportion of catagen or telogen hair follicles, atrophy of sebaceous gland, hyperplasia of keratinocytes in the outer root sheath of HFs and T cell infiltration. [11][12][13][14] The inner root sheaths and outer root sheaths of HF are composed by keratinocytes, which is originated from epidermal keratinocytes that grow vertical downward.…”

Section: Introductionmentioning

confidence: 99%

IL-33 Contributes to the Pathological Changes of Hair Follicles in Psoriasis: A Potential Target for Psoriatic Alopecia

Dai¹,

Chen²,

Jiao³

et al. 2023

CCID

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IL-33 is constitutively expressed in skin tissues. Alopecia, a T cells-driven disorder of the hair follicles (HFs), is a common complication in the development of psoriasis. However, the role of IL-33 in psoriatic alopecia remains uncovered. Here, we investigated the roles of IL-33 in inducing pathological changes of hair follicles in psoriasis. Patients and Methods: Clinical samples and imiquimod (IMQ)-induced psoriatic mice samples were used to investigate the pathological changes and T-cell infiltration of HFs. By using immunohistochemistry staining, the distribution and expression alteration of IL-33 in HFs were determined. Next, by using IL-33 and ST2 knockout mice, we investigated the role of IL-33/ST2 axis in the pathological changes of HFs in psoriasis. Meanwhile, recombinant IL-33 protein was subcutaneous injected to confirm its effect. Finally, RNA sequencing was used to clarify the genes and signaling pathways that involved in this process. Differentially expressed genes were further verified by RT-PCR in cultured HFs in vitro. Results: We found that the pathological changes of HFs and T cells infiltration in imiquimod-induced psoriatic mice were similar to that in psoriasis patients. The IL-33 positive keratinocytes in the outer root sheath of HFs were increased in both psoriasis patients and psoriatic model mice compared with the controls. By using gene knockout mice, we found that the pathological changes and T cell infiltration were attenuated in IL-33 −/− and ST2 −/− psoriatic model mice. In addition, subcutaneous injection of recombinant IL-33 exacerbated the pathological changes of HFs and T cell infiltration. RNA sequencing and RT-RCR revealed that IL-33 upregulated the transcription of genes related to keratinocytes proliferation and T lymphocytes chemotaxis. Conclusion:Our study identifies that IL-33 promotes the pathological changes of HFs in psoriasis, which contributes to psoriatic alopecia. Inhibition of IL-33 may be a potential therapeutic approach for psoriatic alopecia.

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Follicular psoriasis: an underdiagnosed entity?

Cited by 7 publications

References 5 publications

Exacerbation of Chikungunya Virus Rheumatic Immunopathology by a High Fiber Diet and Butyrate

Exacerbation of Chikungunya Virus Rheumatic Immunopathology by a High Fiber Diet and Butyrate

A Study of Clinical, Dermoscopic and Histopathological Correlation in Follicular Keratotic Diseases

IL-33 Contributes to the Pathological Changes of Hair Follicles in Psoriasis: A Potential Target for Psoriatic Alopecia

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