Shoko Miyamoto, Yasutomo Imai, Masako Matsutani, Makoto Nagai, Kiyofumi Yamanishi, Nobuo Kanazawa and Shin Nishiumi : Exploration of Metabolite Biomarkers to Predict the Efficacy of Dupilumab Treatment for Atopic Dermatitis, Disease Markers, 2023.
(Summary)
Dupilumab (DUP) is the first biological agent used treating atopic dermatitis (AD). Notwithstanding its high cost, the type of patient group for which the drug is effective remains unclear. In this retrospective study, we aimed to identify novel and reliable biomarkers which can be measured before DUP administration and to predict the efficacy of DUP. Serum samples from 19 patients with AD treated with DUP were analysed by metabolome analysis using gas chromatography-mass spectrometry. Total 148 metabolites were detected, and the relative values of the metabolites were compared between the patient group that achieved 75% improvement in Eczema Area and Severity Index 16 weeks after administration of DUP (high responders: HR; n = 11) and that did not (low responders: LR; n = 8). The HR and LR groups had significant differences in the relative values of the eight metabolites (lactic acid, alanine, glyceric acid, fumaric acid, nonanoic acid, ribose, sorbitol, and ornithine), with ribose emerging as the best. Furthermore, we evaluated the serum concentrations of ribose and found that ribose may be a useful metabolite biomarker for predicting the efficacy of DUP in AD.
(Keyword)
Humans / Dermatitis, Atopic / Retrospective Studies / Ribose / Treatment Outcome / Severity of Illness Index / Biomarkers
Shoko Miyamoto and Masaru Natsuaki : A Case of Multiple Foreign Body Granulomas Developed on the Face and Extremities Caused by Injection with Hyaluronic Acid Fillers into Face, Skin Research, 20, 2, 104-109, 2021.
(Summary)
<p>A 69-year-old female with known eosinophilic fasciitis treated using 7.5 mg/day of prednisolone (PSL) was referred to our hospital for painful skin lesions following cosmetic treatment. One month before the first clinical visit, she received injections of hyaluronic acid fillers in the corners of her mouth at a cosmetic surgery clinic. Painful erythema and indurative lesions developed at the injection sites one week later, and she received hyaluronidase injections at the cosmetic surgery clinic. Subsequently, infiltrative erythema developed at non-injected sites on her face, left upper arm, and right thigh, and she was referred to our hospital. Histopathological examination of a biopsy specimen from indurated erythema on her right thigh revealed a foreign body granuloma in the subcutaneous tissue and the lower dermis. We administered 15 mg of PSL (total PSL dose :22.5 mg/day) and her symptoms gradually improved. She is currently being followed up with a tapered dose of PSL (12 mg/day). Most reported cases of foreign body granuloma after hyaluronic acid filler injections occurred at the injection sites. However, in this case, multiple cutaneous lesions of foreign body granuloma appeared at both the injected and non-injected sites. This is a rare case and suggested an association with the underlying eosinophilic fasciitis. Skin Research, 20 : 104-109, 2021 </p>
(Keyword)
eosinophilic fasciitis / foreign body granuloma / hyaluronic acid filler
Shoko Miyamoto, Shoichiro Minami, Yujiro Nitta, Megumu Inoue, Takahisa Ibii, Hayato Kimura, Makoto Terada, Mayu Fujimoto and Masahito Tarutani : Localized Cutaneous Nodular Amyloidosis with Different Clinical Features in the Epigastric Region and the Vulva, Skin Research, 20, 4, 299-308, 2021.
(Summary)
A 62-year-old female was referred to our hospital for examination of a skin lesion on her left epigastric region, which developed 6 years before her first visit to our hospital. Orange-yellow or red papules aggregated and fused to form a slightly hard, shiny plaque on her left epigastric region. Furthermore, soft, partly wrinkled, and skin-colored or pink nodules developed on her left vulva 2 years before her visit. Histopathological examination of both skin lesions revealed amyloid deposition derived from immunoglobulin light chain kappa. Around the same time, she visited the department of urology for pain in her genital area and was diagnosed with bladder amyloidosis. Amyloid deposition was confirmed in her skin and bladder, but she was diagnosed with localized amyloidosis based on the amyloid-deposited organs, laboratory findings, and clinical course. The skin lesions on her epigastric region and vulva exhibited different clinical features, but both lesions were diagnosed as localized cutaneous nodular amyloidosis due to the histopathological findings. According to previous reports, localized cutaneous nodular amyloidosis exhibits many clinical features, and it may be overlooked in daily medical practice. Skin Research, 20 : 299-308, 2021
Shoko Miyamoto, Yasutomo Imai, Yukako Inoue, Makoto Nagai, Masaru Natsuaki and Kiyofumi Yamanishi : Three Cases of Generalized Pustular Psoriasis Successfully Treated with an Infliximab Biosimilar, Skin Research, 19, 3, 190-196, 2020.
(Summary)
Case 1 is a 54-year-old female. Erythema appeared on her right upper arm and left wrist 10 days before the first visit. As the erythema had spread to her entire body and pustules had appeared, she was referred to our hospital. Her drug history raised suspicions of acute generalized exanthematous pustulosis, but systemic corticosteroid therapy was ineffective. Her poor response to corticosteroid therapy and the finding of an IL36RN gene mutation in a genetic test led to a decision to treat her for generalized pustular psoriasis. Her symptoms were improved after treatment with an infliximab biosimilar. Case 2 is a 36-year-old female. She developed psoriasis vulgaris at about age 20, and she had been treated by a local dermatologist since then. Erythema with small pustules appeared 10 months before her first visit, and she had started taking apremilast 5 months before that visit. Her symptoms were not improved, and she was referred to our hospital. She was given a diagnosis of generalized pustular psoriasis and treated with granulocyte and monocyte adsorptions plus an infliximab biosimilar, and her symptoms were improved. Case 3 is a 66-year-old man. At about age 15, he developed erythema and scales on his head. At about age 33, he developed a fever, and erythema with pustules appeared on his trunk. He had a diagnosis of generalized pustular psoriasis by a local dermatologist. He started taking etretinate, and his symptoms were improved. However, 1 month before the first visit, his erythema with pustules recurred and he was referred to our hospital. His symptoms improved after treatment with an infliximab biosimilar. Infliximab biosimilar drugs are approved for psoriasis by extrapolated drug reaction, and their efficacy and safety for generalized pustular psoriasis in Japan are unclear. In our hospital, an infliximab biosimilar was effective in all three cases, although the combination of an infliximab biosimilar with granulocyte and monocyte adsorptions or etretinate may contribute to that results. Skin Research, 19 :190-196, 2020