Cutaneous T cell lymphoma atlas reveals malignant T2 cells supported by a B cell-rich tumor microenvironment.

Cutaneous T cell lymphoma (CTCL) is a potentially fatal clonal malignancy of T cells primarily affecting the skin. The most common form of CTCL, mycosis fungoides, can be difficult to diagnose, resulting in treatment delay. We performed single-cell and spatial transcriptomics analysis of skin from patients with mycosis fungoides-type CTCL and an integrated comparative analysis with human skin cell atlas datasets from healthy and inflamed skin.

Cumulative methotrexate dose is not associated with liver fibrosis in patients with a history of moderate-to-severe psoriasis.

Background: There are established risk factors for liver fibrosis (LF), but data on the impact of methotrexate on LF in patients with psoriasis are lacking.

Objectives: This cross-sectional study aimed to determine the prevalence of LF in patients with psoriasis and to evaluate the relationship between LF, cumulative methotrexate dose and other LF risk factors.

Methods: Adults with a history of moderate-to-severe chronic plaque psoriasis were recruited between June 2020 and March 2021.

Individualised computational modelling of immune mediated disease onset, flare and clearance in psoriasis.

Despite increased understanding about psoriasis pathophysiology, currently there is a lack of predictive computational models. We developed a personalisable ordinary differential equations model of human epidermis and psoriasis that incorporates immune cells and cytokine stimuli to regulate the transition between two stable steady states of clinically healthy (non-lesional) and disease (lesional psoriasis, plaque) skin. In line with experimental data, an immune stimulus initiated transition from healthy skin to psoriasis and apoptosis of immune and epidermal cells induced by UVB phototherapy returned the epidermis back to the healthy state.

Therapeutic wavelengths of ultraviolet B radiation activate apoptotic, circadian rhythm, redox signalling and key canonical pathways in psoriatic epidermis.

Ultraviolet B radiation (UVB) exerts pleiotropic effects on human skin. DNA damage response and repair pathways are activated by UVB; if damage cannot be repaired, apoptosis ensues. Although cumulative UVB exposure predisposes to skin cancer, UVB phototherapy is widely used as an effective treatment for psoriasis.

The Results of Low-Dose Total Skin Electron Beam Radiation Therapy (TSEB) in Patients With Mycosis Fungoides From the UK Cutaneous Lymphoma Group.

Purpose: Total skin electron beam radiation therapy (TSEB) is a very effective treatment of mycosis fungoides. Following reports of similar durations of response to lower doses of TSEB, a low-dose schedule of TSEB was introduced in the United Kingdom.

Methods And Materials: A protocol of 12 Gy in 8 fractions over a period of 2 weeks was agreed on by use of the Stanford University technique.

Spectral effects of UV on psoriasis.

Ultraviolet B (UVB) is a highly effective, relatively safe, affordable and widely used therapeutic option for moderate psoriasis. Several types of UVB lamp are available to treat psoriasis, both broadband and narrowband, allowing a choice of spectral emission. However despite years of clinical use, the mechanism of action of UVB in clearing psoriasis remained incompletely understood.

Keratinocyte apoptosis in epidermal remodeling and clearance of psoriasis induced by UV radiation.

Psoriasis is a common chronic skin disorder, but the mechanisms involved in the resolution and clearance of plaques remain poorly defined. We investigated the mechanism of action of UVB, which is highly effective in clearing psoriasis and inducing remission, and tested the hypothesis that apoptosis is a key mechanism. To distinguish bystander effects, equal erythemal doses of two UVB wavelengths were compared following in vivo irradiation of psoriatic plaques; one is clinically effective (311  nm) and one has no therapeutic effect on psoriasis (290  nm).

Eczema in pregnancy.

Many women with eczema experience flares during pregnancy, and management must take account of the possible effects of some treatments on the fetus

Management of psoriasis in pregnancy.

Many treatments for this chronic skin disease are harmful to the developing fetus, so careful pre-conception planning and management adjustment are crucial for the pregnant patient