Publications by authors named "Kelsey R Van Straalen"
Disease heterogeneity and molecular classification of inflammatory palmoplantar diseases.
J Allergy Clin Immunol
November 2024
Article Synopsis
- Palmoplantar pustulosis (PPP), palmoplantar psoriasis (palmPP), and dyshidrotic palmoplantar eczema (DPE) are inflammatory skin conditions that can be difficult to distinguish from one another due to similar clinical presentations.
- Recent RNA sequencing studies of these conditions revealed overlapping inflammatory responses, particularly involving proinflammatory cytokines and immune processes, alongside unique features for each disease.
- The findings suggest that current classifications based on clinical symptoms may be insufficient, emphasizing the need for a better molecular understanding of these diseases to improve diagnosis and treatment.
Methods for describing and reporting the clinical and histologic characteristics of cutaneous tissue samples from patients with hidradenitis suppurativa (HS) are not currently standardized, limiting clinicians' and scientists' ability to uniformly record, report, and communicate about the characteristics of tissue used in translational experiments. A recently published consensus statement outlined morphological definitions of typical HS lesions, but no consensus has been reached regarding clinical characterization and examination of HS tissue samples. In this study, we aimed to establish a protocol for reporting histopathologic and clinical characteristics of HS tissue specimens.
View Article and Find Full Text PDFHidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by abscesses, nodules, dissecting/draining tunnels, and extensive fibrosis. Here, we integrate single-cell RNA sequencing, spatial transcriptomics, and immunostaining to provide an unprecedented view of the pathogenesis of chronic HS, characterizing the main cellular players and defining their interactions. We found a striking layering of the chronic HS infiltrate and identified the contribution of 2 fibroblast subtypes (SFRP4+ and CXCL13+) in orchestrating this compartmentalized immune response.
View Article and Find Full Text PDFBiology of Interleukin-17 and Novel Therapies for Hidradenitis Suppurativa.
J Interferon Cytokine Res
December 2023
Article Synopsis
- * In 2011, researchers found elevated levels of IL-17 in HS lesions, leading to advancements in understanding the disease and ultimately the FDA approval of secukinumab, a monoclonal antibody targeting IL-17A, in June 2023 for moderate to severe HS.
- * The review covers HS's epidemiology, clinical features, and the IL-17 pathway, while also discussing clinical trial results for IL-17 inhibitors and comparing secukinumab with adalimumab
Importance: Although several clinician- and patient-reported outcome measures have been developed for trials in hidradenitis suppurativa (HS), there is currently no consensus on which measures are best suited for use in clinical practice. Identifying validated and feasible measures applicable to the practice setting has the potential to optimize treatment strategies and generate generalizable evidence that may inform treatment guidelines.
Objective: To establish consensus on a core set of clinician- and patient-reported outcome measures recommended for use in clinical practice and to establish the appropriate interval within which these measures should be applied.
Article Synopsis
- The study investigates the effectiveness of combining adalimumab, a biologic treatment, with surgery versus using adalimumab alone in patients with moderate to severe hidradenitis suppurativa.
- Results show that the combination treatment led to significantly better reductions in both the severity of the disease and improvements in quality of life after 12 months compared to monotherapy.
- The study has limitations, including a short follow-up period that prevents assessment of long-term surgical recurrence rates.
Article Synopsis
- The study evaluated the effectiveness of guselkumab, an anti-IL-23p19 monoclonal antibody, for treating moderate-to-severe hidradenitis suppurativa (HS) over 16 weeks.
- A phase IIa trial showed that 65% of patients achieved significant clinical improvement, with decreases in Hidradenitis Suppurativa Clinical Response (HiSCR) scores and inflammatory nodules.
- Even though inflammatory markers in the skin were reduced in responders, overall patient-reported outcomes did not reflect significant improvement, and only one serious adverse event occurred, deemed likely unrelated to the treatment.
Article Synopsis
- A new parameter called IHS4-55, which indicates a 55% reduction in the severity of Hidradenitis Suppurativa (HS), was validated using data from patients treated with adalimumab and placebo.
- The research aimed to externally validate the IHS4-55 in patients treated with antibiotics, assessing its correlation with the reduction of inflammatory lesions and quality of life metrics.
- Results from a study of 283 patients showed that those achieving IHS4-55 experienced significant reductions in inflammatory nodules and had a greater likelihood of improving quality of life scores, supporting its use as a key outcome measure in clinical trials.
Article Synopsis
- A new dichotomous outcome measure, IHS4-55, was created and validated for assessing hidradenitis suppurativa (HS) in clinical trials and practice, focusing on a 55% reduction in the IHS4 score to indicate improvement.
- The effectiveness of the IHS4-55 was demonstrated through data from the PIONEER studies, showing that patients who met this threshold had better outcomes when treated with adalimumab compared to placebo.
- IHS4-55 shows similar performance to existing measures, providing a reliable tool for evaluating treatment responses in HS patients.
Introduction: Cohort studies on the use of retinoids for hidradenitis suppurativa (HS) have yielded contradicting results. As the clinical presentation of HS is heterogeneous, with different predilection sites and hallmark features, it can be hypothesized that HS phenotypes are associated with the effectiveness of specific retinoid treatments.
Objectives: The aim of this study was to evaluate the drug survival of oral retinoids in the treatment of HS and to establish predictors for longer treatment duration.
Research interest in Hidradenitis Suppurativa (HS) has grown exponentially over the past decades. Several groups have worked to develop novel scores that address the drawbacks of existing investigator-assessed and patient-reported outcome measures currently used in HS trials, clinical practice and research. In clinical trial settings, the drawbacks of the HiSCR have become apparent; mainly, it is lack of a dynamic measurement of draining tunnels.
View Article and Find Full Text PDFHidradenitis suppurativa (HS) is a chronic, debilitating, inflammatory skin disorder with a prevalence of around 1% and a profound impact on patients' quality of life. Characteristic lesions such as inflammatory nodules, abscesses, and sinus tracts develop in the axillae, inguinal, and gluteal areas, typically during or after puberty. A complex interplay of genetic predisposition, hormonal factors, obesity, and smoking contributes to development and maintenance of the disease.
View Article and Find Full Text PDFImportance: Chronic pain is one of the most prominent symptoms of hidradenitis suppurativa (HS) and an independent domain in the core outcome set for HS. Previously, the chronic, recurrent, inflammatory nature of HS was hypothesized to induce central sensitization (CS; alteration and amplification of pain perception). However, evidence for this hypothesis is currently lacking.
View Article and Find Full Text PDFArticle Synopsis
- Hidradenitis suppurativa (HS) is a chronic skin disease caused by inflammation in hair follicles, leading to painful nodules, abscesses, and draining tunnels filled with immune cells and inflammatory cytokines.
- Currently, adalimumab is the only approved medication for HS, despite various clinical trials exploring the effectiveness of other biologics targeting cytokines like TNF-α and IL-1.
- The review outlines evidence-based use of available biologics and small molecules in therapy, discusses integration with medical and surgical treatments, and highlights new treatment targets under investigation for managing HS.
Background: Tetracyclines and clindamycin plus rifampicin combination therapy are both considered first-line therapy in current hidradenitis suppurativa guidelines. However, evidence for their efficacy is drawn from small studies, often without validated outcomes.
Objective: To assess the 12-week efficacy of oral tetracyclines and a combination of clindamycin and rifampicin.
Importance: Hidradenitis suppurativa is a chronic, inflammatory skin disease in which genetic factors are considered to play a role, with up to 38% of patients reporting a family history. Variations in the γ-secretase genes are found mainly in familial cases with an autosomal dominant pattern of inheritance. These variations are rare in the general population with hidradenitis suppurativa, even in patients who report a family history of the disease.
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