Tofacitinib for the Treatment of Three Immune-mediated Conditions in One Patient: Ulcerative Colitis, Pyoderma Gangrenosum, and Alopecia Areata

Author(s):  
Rocio Sedano ◽  
Vipul Jairath
2021 ◽  
Vol 79 (4) ◽  
pp. 309-314
Author(s):  
Francisca Morgado ◽  
Rui Oliveira Soares

In recent years, several studies have demonstrated the involvement of the intestinal microbiota in immune-mediated diseases such as diabetes, ulcerative colitis, and multiple sclerosis. There are few data on the follicular microbiome and its role in the pathogenesis of scalp diseases. Some studies show influence of dysbiosis on these diseases, and manipulation of the microbiome may represent a possible therapeu- tic option. This article reviews current knowledge regarding the impact of dysbiosis on dermatological diseases of the scalp, such as seborrheic dermatitis, psoriasis, alopecia areata, androgenetic alopecia, lichen planus pilaris, frontal fibrosing alopecia and decalvant folliculitis. A broader understanding of this may suggest additional treatments beyond conventional therapies.


Author(s):  
Abdullah Abualiat ◽  
Hala Edris ◽  
Salaheldin Alfadni ◽  
Tariq Aziz ◽  
Mahmoud Hussein

Pyoderma Gangrenosum (PG) is a rare chronic immune-mediated inflammatory dermatosis manifested as painful skin ulceration, commonly affecting the lower limbs. The pathogenesis of the disease is complex. Abnormalities in neutrophil function, dysregulation of the innate immune system, and Tumor Necrosis Factor (TNF) were postulated. An underlying associated systemic disease was reported in more than 50% of PG patients, including inflammatory bowel disease, rheumatoid arthritis, and malignancies, with few cases reported an associated thyroid disease. Authors report a case of extensive PG associated with both ulcerative colitis and thyrotoxicosis co-morbidities not mentioned before in one patient. The patient was successfully treated with the anti-TNF alpha infliximab.


2013 ◽  
Vol 75 (2) ◽  
pp. 149-153 ◽  
Author(s):  
Masako INOUE ◽  
Koichi IZUMIKAWA ◽  
Yasutaka SUZAKI

2021 ◽  
Vol 13 ◽  
pp. 1759720X2097777
Author(s):  
Maria Sole Chimenti ◽  
Paola Conigliaro ◽  
Livia Biancone ◽  
Roberto Perricone

Psoriatic arthritis (PsA) and ulcerative colitis (UC) are immune-mediated diseases that cause significant burden worldwide. Recent advances in their management have improved patient outcomes. However, significant unmet needs still remain as not all patients respond to current treatments, and patients may lose responsiveness over time. An improved understanding of the pathophysiology of these diseases has brought about the development of novel disease-modifying agents, including interleukin inhibitors and, more recently, Janus kinase (JAK) inhibitors. With the approval of tofacitinib for the treatment of adults with active PsA and in adult patients with moderately-to-severely active UC, JAK inhibitors have recently entered the treatment armamentarium for PsA and UC. A number of other JAK inhibitors are also undergoing clinical development and are currently in phase III trials. This review provides an overview of the current therapeutic options for PsA and UC, with a focus on the JAK inhibitors.


2020 ◽  
Vol 26 (7) ◽  
pp. 971-973 ◽  
Author(s):  
Melissa H Rosen ◽  
Jordan Axelrad ◽  
David Hudesman ◽  
David T Rubin ◽  
Shannon Chang

Abstract First detected in Wuhan, China, the novel 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped RNA beta-coronavirus responsible for an unprecedented, worldwide pandemic caused by COVID-19. Optimal management of immunosuppression in inflammatory bowel disease (IBD) patients with COVID-19 infection currently is based on expert opinion, given the novelty of the infection and the corresponding lack of high-level evidence in patients with immune-mediated conditions. There are limited data regarding IBD patients with COVID-19 and no data regarding early pregnancy in the era of COVID-19. This article describes a patient with acute severe ulcerative colitis (UC) during her first trimester of pregnancy who also has COVID-19. The case presentation is followed by a review of the literature to date on COVID-19 in regard to inflammatory bowel disease and pregnancy, respectively.


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