News of the Month: June 2022

Immuno Solid-Phase Allergen Chip Identifies Sensitization Profiles in Patients With AD

According to a study published in the International Archives of Allergy and Immunology, microarray ImmunoCAP immuno solid-phase allergen chip (ISAC) differentiates a patient’s sensitization profile, but it is insufficient to diagnose clinically relevant immediate- or late-type birch pollen-related food allergies in patients with atopic dermatitis (AD).

Researchers aimed to define sensitization profiles, evaluate whether ImmunoCAP test results are predictors of identifying patients who experience a late eczematous response by ingesting birch pollen-related food, correlate allergen microarray test results to established fluorescence enzyme immunoassay (FEIA) results, and determine the diagnostic validity for the diagnosis of immediate- and/or late-type reactions to birch pollen-related food in children and adults with AD.

The study investigators performed a double-blind, placebo-controlled food challenge involving children and adults who had AD, existing IgE-mediated birch pollen sensitization, and suspected birch pollen-related food allergy. Of a total of 19 children and adults with AD, 63% experienced an allergic reaction and worsening of AD during the food challenge. No difference in AD frequency of inhalant allergies, age, and severity was demonstrated between responders and nonresponders. The microarray analysis confirmed results from ImmunoCAP FEIA on specific IgE in patients with AD and suspected birch pollen-related food allergy.

“In conclusion, our current work confirms that allergen microarray ImmunoCAP ISAC allows a precise differentiation of the patient’s sensitization profile from their response to Bet v 1-homolog aero- and food allergens, as well as to other recombinant and native allergen components,” concluded the study authors. “However, microarray analysis is not a suitable diagnostic tool to discriminate neither between subjects with a clinically relevant birch pollen-related food allergy nor between those with a late-type eczematous reaction to birch pollen-related foods (apple, carrot, celery, and/or hazelnut) and those who did not show a worsening of AD upon oral food challenge,” they added.

Reference
Wassmann-Otto A, Heratizadeh A, Wichmann K, Werfel T. Microarray analysis confirms ImmunoCAP-fl uorescence enzyme immunoassay results on specific IgE in patients with atopic dermatitis and suspected birch pollen-related food allergy. Int Arch Allergy Immunol. Published online April 4, 2022. doi:10.1159/000522525

Incretin Levels May Predict Insulin Resistance Among Patients With Acne

Incretin may be used as a biomarker of insulin resistance in patients with acne vulgaris (AV), according to a recent study published in the Journal of Cosmetic Dermatology.

Researchers aimed to investigate the relationship between serum incretin, AV, and insulin resistance, and to identify biological indicators of AV with insulin resistance. A total of 60 patients were included in the study wherein blood was tested for serum incretin, blood lipids, sex hormones, and insulin release.

Incretin levels were lower in patients with AV who had insulin resistance compared with patients who had AV without insulin resistance. Researchers also found that the insulin resistance index decreased as incretin levels increased.

“Insulin resistance in patients with acne vulgaris is negatively correlated with incretin,” concluded the study authors. “Serum incretin may be expected to be a biomarker for diagnosing acne vulgaris patients with insulin resistance,” they added.

Reference
Khattab FM, Fawzy M. Incretin serum level as a biomarker of insulin resistance in acne vulgaris patients. J Cosmet Dermatol. Published online April 28, 2022. doi:10.1111/jocd.15025

Education Level and Surgical Location Influence Perioperative Anxiety Associated With Mohs

Patient education level and surgical location influence the level of perioperative anxiety associated with Mohs micrographic surgery (MMS), according to a study published in Dermatologic Surgery.

Researchers aimed to identify risk factors associated with anxiety concerning MMS among patients with nonmelanoma skin cancer in a cross-sectional case series. Information on patient demographics and surgical locations was collected to measure perioperative anxiety and quality of life. Potential risk factors that predict MMS-associated anxiety were also identified.

MMS performed in the eyelid area increased perioperative anxiety compared with the noneyelid facial area and nonfacial area. Patients with graduate degrees showed less anxiety compared with patients who had a lower educational level. A greater impact on quality of life was determined in patients with higher perioperative anxiety.

“This study identified that surgical location and the patient’s educational level are 2 critical predicting factors for perioperative anxiety,” concluded the study authors. “Furthermore, perioperative anxiety could negatively affect a patient’s quality of life and warrants further investigation into effective management,” they added.

Reference
Long J, Rajabi-Estarabadi A, Levin A, Nami N, Nouri K. Perioperative anxiety associated with Mohs micrographic surgery: a survey-based study. Dermatol Surg. Published online April 18, 2022. doi:10.1097/DSS.0000000000003455

Psoriasis Is Accompanied by Stromal Thickening of the Cornea

Psoriasis occurs along with stromal thickening of the cornea without conjunctival stromal involvement, according to a study published in International Ophthalmology.

Using anterior segment optical coherence tomography, researchers aimed to evaluate the epithelial and stromal thickness of conjunctiva and cornea in patients with psoriasis. This cross-sectional study included 61 patients with psoriasis and 42 age-matched healthy control individuals.

The tear breakup time and Schirmer-1 test values were lower in patients with psoriasis compared with the control group, but conjunctival and corneal epithelial thickness did not differ between the 2 groups. However, the central corneal stroma was thicker in the psoriasis group, and the Psoriasis Area and Severity Index score was positively correlated with the thickness of the central corneal stroma in the nail psoriasis group.

“Psoriasis is not associated with altered epithelial thicknesses of the cornea and conjunctiva,” concluded the study authors. “It is accompanied by the stromal thickening of the cornea without conjunctival stromal involvement,” they added.

Reference
Ersan I, Kilic S, Isik S. Evaluation of ocular surface epithelial and stromal thicknesses in psoriasis using anterior segment optical coherence tomography. Int Ophthalmol. Published online April 7, 2022. doi:10.1007/s10792-022-02289-3