In some patients, the chronic inflammatory skin diseases psoriasis and
eczema are similar in appearance. Up to now, dermatologists have
therefore had to base their decision on which treatment should be
selected on their own experience and an examination of tissue samples. A
team of researchers has now analyzed the molecular processes that occur
in both diseases and discovered crucial differences. This has enabled
them for the first time to gain a detailed understanding of the ways in
which the respective disease process occurs.
A better understanding of molecular processes
"Both diseases have a highly complex appearance, which often varies
widely from one patient to another," says Dr. Stefanie Eyerich, who
heads the Specific Immunology working group at the Institute of Allergy
Research (IAF) at the Helmholtz Zentrum München. "This has led previous
attempts to compare their molecular signature to fail." In this study,
the researchers identified 24 patients who were suffering simultaneously
from psoriasis and eczema and in each analyzed at the molecular level
the characteristic differences they demonstrated between psoriasis and
eczema compared to clinically unremarkable skin.
"We were thus able to drastically reduce random genetic or
environmental influences and gain a detailed picture of the development
of these two diseases," explains Prof. Fabian Theis of the Institute of
Computational Biology (ICB) at the Helmholtz Zentrum München.
Paving the way for personalized medicine
In recent years, many new specific treatments have been developed for
psoriasis and eczema. However, in each case, these are only effective
for one or other of the two diseases. And they are very expensive: one
such treatment generally costs several tens of thousands of euros per
year, per patient. The ability to make an exact diagnosis therefore has a
considerable economic impact.
If it cannot be clearly determined on presentation which of the two
diseases is involved, the newly developed diagnostic tool will help to
differentiate them. It involves a test which compares samples of
diseased and healthy skin and is concluded within one day. The
researchers have now filed a patent application for it.
The procedure, moreover, marks the first step towards the
introduction of personalized medicine also for chronic inflammatory skin
diseases. "Whereas this is practiced increasingly in oncology, for
example in the form of mutation analyses and the subsequent decision in
favor of the best individual treatment option, it is not common in the
case of inflammatory skin diseases," says Kilian Eyerich of the Clinic
and Polyclinic for Dermatology at the Technical University of Munich.
The researchers plan to purse this path with a view to characterizing
even more precisely the molecular processes involved in inflammatory
skin diseases and combining them with clinical information, such as the
choice of certain treatments. In this way, their goal is to determine
the best possible treatment option for each individual patient.
Further information
*Psoriasis is a non-contagious, inflammatory skin disease, and it can
also be a systemic disease that affects other organs. It generally
presents as very flaky patches of skin varying in size from spots to
larger areas the size of one's palms (frequently on the knees, the
elbows and on the scalp, and also on the anus) -- often with severe
itching as well as nail changes. Worldwide about 125 million people
suffer from this disease. In Germany it affects about two million
people.
**Eczema is a skin disease that presents as a non-infectious
inflammatory skin reaction. Eczema can be triggered by different
factors. It is characterized by a typical sequence of skin reactions
(reddening of the skin, blistering, weeping, scabbing, scaling).
http://www.sciencedaily.com/releases/2014/07/140710081210.htm
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