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Category: integumentary system

How can Opzelura reverse skin discoloration in vitiligo?

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On December 25, 2024

In endocrine system, integumentary system, lymphatic and immune system

Teachable moment in classrooms:

  1. integumentary system – layers/strata of epidermis
  2. integumentary system – melanocytes produce melanin for skin pigmentation
  3. immune system chapter – the white blood cells called cytotoxic (CD8) T lymphocytes can kill invaders and infected cells
  4. endocrine system chapter – some hormone receptors in the cell membrane send chemical signals to the inside of the cell

The news item:  Recently the following new item appeared online:

More Vitiligo Patients Respond with Longer Use of Opzelura

Longer-term use of Opzelura was well tolerated, with no serious treatment-related adverse events, according to a poster presented at the annual dermatology meeting.

The article states that vitiligo is a disorder where skin loses color, and that it is likely an autoimmune reaction. The article also states that Opzelura is a Janus kinase (JAK) inhibitor, and that JAK signaling is responsible for inflammation in vitiligo.

So, Why Do I Care??  While vitiligo is not a life-threatening condition, the appearance of “bleached” white spots on the face or hands hinders social interactions, and may cause social withdrawal, and associated psychological stress of vitiligo sufferers. The improved coloration of the skin through medical treatment increases quality of life by lowering the psychological stress.

Plain English, Please!!!   First, let’s talk about how normal skin pigmentation is created. The deepest layer of the epidermis is called stratum basale, and in that layer, scattered among keratinocytes, we find the cells called melanocytes that make the brownish pigment called melanin. Melanin is exocytosed, secreted, from melanocytes, and then neighboring keratinocytes of stratum basale and stratum spinosum endocytose, soak up melanin. Inside the keratinocytes melanin protects the DNA from UV light.

Second, let’s talk about how vitiligo changes skin pigmentation.  People with vitiligo has melanocytes that are more sensitive to UV light or chemical stress.  The stressed melanocytes release stress-related

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Can we use gene therapy to fight the skin disorder epidermolysis bullosa?

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On March 29, 2024

In chemical basis of life, integumentary system, tissues

Teachable moment in classrooms:

  1. cellular basis of life chapter – concept of one gene, one protein
  2. cellular basis of life chapter – concept of gene mutation leading to protein malfunction
  3. tissue chapter – the basement membrane is a thin layer of tissue in-between epithelium and the underlying connective tissue
  4. integumentary system chapter –the integrity of the skin depends on the secure connection of the dermis to the basement membrane

The news item:  Recently the following news item appeared online:

U.S. FDA approves Krystal Biotech’s skin-disorder gene therapy

(Reuters) -The U.S. Food and Drug Administration on Friday approved Krystal Biotech Inc’s first-of-its kind topical gene therapy for patients with a genetic skin disorder, sending its shares up 7% in afternoon trading. Patients with the rare dystrophic epidermolysis bullosa disorder suffer from open wounds, causing skin infections and are at an increased risk of vision loss, scarring and skin cancer.

The article states that the therapy named Vyjuvek healed skin wounds in 65% of dystrophic epidermolysis bullosa patients as opposed to 22% healing rate with placebo treatment. The article also states that about 10,000 people world-wide, and 3000 people in the USA suffer from the disorder.

So, Why Do I Care??  While severe forms of epidermolysis bullosa are life-threatening, moderate forms are devastating to the quality of life, as they it creates painful wounds or blisters on the skin, or in the mouth, and the healing wounds lead to widespread scarring. That makes dressing into clothes, wearing shoes, eating difficult. For dystrophic epidermolysis bullosa patients the promise is the possibility of returning to a normal lifestyle after this new treatment.

Plain English, Please!!!  First, let’s talk about epidermolysis bullosa. This is a group of diseases with the shared symptoms of fragile, easy to break skin and blistering of the skin. The three-layered area of epithelium-basement membrane-dermis is made sturdy by several molecules, and if one is malfunctioning because of a mutation, then fragility of the skin results. The many types of epidermolysis bullosa are caused by a variety of genetic mutations.

Second, let’s talk about the cause of dystrophic epidermolysis bullosa. In this type of the disease the missing component is type VII collagen, the molecule that secures the basement membrane to the dermis. Imagine a large picnic table where the table cover is clamped to the table so the wind wouldn’t blow the cover away. Type VII collagen acts like those clamps securing the dermis (the table) to the table cover (the basement membrane). When the type VII college gene suffers mutations, the resulting type VII collagen protein clamp has a distorted shape, and cannot secure the basement membrane to the dermis, and the skin blisters to form open wounds.

Third, let’s talk about how Vyjuvek treatment works. This treatment is delivering a normal type VII collagen gene to the fibroblast cells of the dermis. The gene is enclosed in an inactivated virus, and the viruses are mixed into a gel, and that gel is applied to the wound surface.  Once that virus enters inside the fibroblast in the person’s dermis, then the normal gene is used to make the type VII collagen protein. With time the newly-made, normal type VII collagen “clamps” will secure the dermis to the basement membrane, and prevent new blistering or breaking of the skin.

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Can a nasal spray popularized on TikTok give us a tan?

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On March 26, 2022

In cellular basis of life, endocrine system, integumentary system

TeachableMedicalNews article 03272022

Teachable moment in classrooms:

  1. chemical basis of life – proteins are made of amino acid building blocks
  2. integumentary system – layers (strata) of the epidermis
  3. integumentary system chapter – melanocytes make the brown pigment melanin
  4. endocrine system chapter – anterior pituitary makes the melanocyte stimulating hormone

The news item:  Recently a report appeared about TikTok influencers who inhale nasal spray to get a tan:

I inhale dangerous tanning nasal sprays because I’d rather die hot than live ugly

Beauty influencers are taking to TikTok to show themselves snorting sprays that they claim give them a golden tan – but doctors warn the products could be both ineffective and dangerous.

The article states that the influencers claim to get a glowing bronze skin color from the inhaled spray, that the spray has the active ingredient dihydroxy methylchromonyl palmitate which is not approved for inhalation, and that the TikTok posts have hundreds of thousands likes.

So, Why Do I Care??  Social media influencers can act very convincingly, even when they encourage unhealthy actions for their followers. The use of a chemical designed to be used on top of the skin may damage the nasal passages, or it may cause serious illness. This is a great example of how vigilant and skeptical we have to be when seeing something that looks too good to be true.

Plain English, Please!!!

First, let’s talk about the natural process that gives skin a tanned color. In the top region, the epidermis, of the skin there are cells called melanocytes that make a brown-colored pigment called melanin.

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Why breast implants can become life threatening?

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On November 7, 2020

In cellular basis of life, integumentary system, lymphatic and immune system

TeachableMedicalNews article 11072020

Teachable moment in classrooms:

  1. cellular basis of life chapter – gene mutation leading to malfunctioning protein
  2. cellular basis of life chapter – mitosis or somatic cell division
  3. integumentary system chapter – scar tissue formation during dermal wound healing
  4. immune system chapter – lymph nodes as location of lymphocytes
  5. immune system chapter – cell division as part of immune response in lymph nodes.

The news item:  Recently a recall of breast implants was in the news:

Breast implants tied to rare form of cancer recalled at FDA request

Allergan Inc. announces a worldwide recall of implants with a textured surface

The report described how one type of breast implant made by Allergan is associated with the development of a rare cancer, called anaplastic large cell lymphoma (ALCL).

So, Why Do I Care??  Altogether close to 600 anaplastic large cell lymphoma cases have been reported in women with breast implants. Even such a relatively slow number of cancers is a concern, because most of those cases occurred in women with one type of implant. Add to this that breast implants have been considered as a cosmetic alteration that presents little danger, but now a specific disorder is associated with them. That is a substantial change in how we view the risks of this procedure

Plain English, Please!!!

First, let’s talk about how a breast implant affects the body. This cosmetic implant is made of plastic, and it is surgically inserted under the skin. The normal wound

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Can anyone be born without skin?

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On March 14, 2020

In cellular basis of life, chemical basis of life, integumentary system, tissues

TeachableMedicalNews article 03132020

Teachable moment in classrooms:

  1. chemical basis of life chapter – concept of one gene, one protein
  2. cellular basis of life chapter – gene mutation leading to protein  malfunction
  3. tissue chapter – junctional structures, hemidesmosomes
  4. integumentary system chapter – functions of epidermis

The news item:  Recently an article appeared about a newborn who was missing a good part of his skin:

Baby born without skin puzzles doctors, but mom says ‘we have faith, that’s all that matters’

Houston doctors are running tests to diagnose a baby born with most of his skin missing. Mom’s only been able to hold baby twice in three months.

The article mentioned the disorder epidermolysis bullosa, genetic testing for diagnosis, and the low frequency of this disorder.

So, Why Do I Care??  While the combination of the aplasia cutis and

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Can genetic information guide personalized timing of radiation therapy?

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On December 15, 2019

In cellular basis of life, integumentary system, nervous system

TeachableMedicalNews article 12152019

Teachable moment in classrooms:

  1. cellular basis of life chapter – cancer cell formation
  2. cellular basis of life chapter – DNA and membrane damage from radiation
  3. nervous system chapter – circadian rhythm directed by reticular formation and the hypothalamus
  4. integumentary system chapter – stem cells of epidermis in stratum basale

The news item:  This article describes promising research into minimizing radiation toxicity in cancer patients:

Use genetic data to predict the best time of day to give radiotherapy to breast cancer patients, say researchers

A new clinical study led by the University of Leicester and conducted in the HOPE clinical trials facility at Leicester’s Hospitals has revealed the pivotal role that changing the time of day that a patient receives radiotherapy could play in altering radiotherapy toxicity.

The article mentions PER3 and NOCT genes of circadian rhythm, and how they change skin biology, and the adverse response of skin to radiation therapy.

So, Why Do I Care??  Many types of cancers are treated with radiation therapy, bringing the total to over 3 million patients every year in the USA.  While radiation therapy is successful in reducing cancer growth, the treatment has several side effects, called radiation toxicity.  One of those side effects is the thickening and reddening of the skin.  Any approach that reduces the side effects of the treatment will increase the comfort and quality of life of millions of cancer patients.

Plain English, Please!!!

First, let’s talk about radiation therapy. The eradication of the cancer cells in cancer patients can be achieved by surgery, chemotherapy, and by radiation therapy.  The radiation is nothing else but invisible rays that are aimed at the body part that has the cancer; those rays kill the cancer cells by damaging their DNA and the cell membrane. As the radiation comes from a machine, those killer rays must pass through the skin in order to reach cancer inside the body.

Second, let’s talk about skin reaction to radiation.  No surprise that the very rays that destroy cancer cells also damage the skin as the rays are passing through it.  Think about how the rays from the Sun pass through the skin, and cause sunburn.  Cells in the actively growing layer of the skin are damaged most, and that layer has to regenerate to keep the skin functioning.  That regeneration is making the skin red, and thick, painful, cracked, and even bleeding.  This is worse than the dry and cracked skin you get in the winter time.

Third, let’s talk about circadian rhythm.  We feel sleepy at night, and wake up in the morning, because of the daily rhythm directed by our nervous system.  That daily rhythm is called the circadian rhythm.  As it turns out our skin regenerates better at certain times of the day, so the skin regeneration is also moving along a circadian rhythm.  People with specific version of the genes called Per3 and Noct have skin rhythms with better regeneration in the afternoon.  This means that for those patients, identified by genetic analysis, the radiation treatment scheduled for the afternoon will speed up the regeneration, and minimize skin damage.

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