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Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases leading to pruritic skin lesions. A subset of AD patients exhibits a disseminated severe HSV infection called eczema herpeticum (EH) that can cause life-threatening complications. This review gives an overview of the clinical picture, and characteristics of the patients as well as the diagnosis and therapy of EH. A special focus lies on the pathophysiological hallmarks identified so far that predispose for EH. This aspect covers genetic aberrations, immunological changes, and environmental influences displaying a complex multifactorial situation, which is not completely understood. Type 2 skewing of virus-specific T cells in ADEH+ patients has been implicated in immune profile abnormalities, along with impaired functions of dendritic cells and natural killer cells. Furthermore, aberrations in interferon pathway-related genes such as IFNG and IFNGR1 have been identified to increase the risk of EH. IL-4, IL-25, and thymic stromal lymphopoietin (TSLP) are overexpressed in EH, whereas antimicrobial peptides like human β-defensins and LL-37 are reduced. Concerning the epidermal barrier, single nucleotide polymorphisms (SNPs) in skin barrier proteins such as filaggrin were identified in ADEH+ patients. A dysbalance of the skin microbiome also contributes to EH due to an increase of Staphylococcus aureus, which provides a supporting role to the viral infection via secreted toxins such as α-toxin. The risk of EH is reduced in AD patients treated with dupilumab. Further research is needed to identify and specifically target risk factors for EH in AD patients. 相似文献
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Oliver Bader Jana Tünnermann Anna Dudakova Marut Tangwattanachuleeporn Michael Weig Uwe Gro? 《Antimicrobial agents and chemotherapy》2015,59(7):4356-4359
Azole antifungal drug resistance in Aspergillus fumigatus is an emerging problem in several parts of the world. Here we investigated the distribution of such strains in soils from Germany. At a general positivity rate of 12%, most prevalently, we found strains with the TR34/L98H and TR46/Y121F/T289A alleles, dispersed along a corridor across northern Germany. Comparison of the distributions of resistance alleles and genotypes between environment and clinical samples suggests the presence of local clinical clusters. 相似文献
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Paulo Roberto Santos Diego Levi Silveira Monteiro Paulo Henrique Alexandre de Paula Vicente Lopes Monte Neto Maria Leilah Ponte Monte Coelho Cecília Costa Arcanjo Sânkia Maria Lopes Aragão Camila Barbosa Gondim Janaína Teixeira Pereira Carneiro Tapeti Hyngridd Soares Mendes Luise Vasconcelos Vieira Rita de Cássia Parente Prado 《Nephrology (Carlton, Vic.)》2015,20(8):519-522
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Double orifice mitral valve; a coincidental finding. 总被引:1,自引:0,他引:1
Iris C D Westendorp H A C M de Bruin-Bon Jana Hrudova 《European journal of echocardiography》2006,7(6):463-464
A double orifice mitral valve (DOMV) represents a rare congenital malformation characterised by two valve orifices with two separate subvalvular apparatus. This case demonstrates the necessity of careful imaging of the mitral valve apparatus, not only in patients with atrioventricular septal defects, but also in patients with congenital left obstructive heart disease. 相似文献
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