Berit Carlsen - Academia.edu (original) (raw)

Papers by Berit Carlsen

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PubMed, Feb 20, 2017

In this article we give an overview of which skin conditions that are currently treated with lase... more In this article we give an overview of which skin conditions that are currently treated with laser and explains the basic principles of treatment. In addition, we summarize recommendations of the Danish Dermatological Society for demarcation of medical treatments which can be provided free of charge from cosmetic self-payment treatments.

Journal of clinical & experimental dermatology research, 2013

British Journal of Dermatology, Nov 1, 2011

In 2006, the first publication on filaggrin (FLG) mutations hit the international scientific comm... more In 2006, the first publication on filaggrin (FLG) mutations hit the international scientific community. Following the reporting of the great importance of these mutations for the diseases ichthyosis vulgaris (IV) and atopic dermatitis (AD), a variety of reports on genotype–phenotype associations and associations with other skin and nonskin diseases have been published. As a natural consequence, mapping of the FLG mutations in different ethnicities has also received solid attention: most intensively in the European caucasian and the Asian populations with reports from several subpopulations. Even though the prevalence of FLG mutations in patients with AD is similar (17–42% in the caucasian population and 20–30% in the Asian population), the specific mutations vary. The expectation may therefore be that FLG mutations are equally prevalent in an African AD population, but this has not been examined so far. In this issue of BJD, the first study attempting to investigate the role of FLG mutations in an African population is published. In the present case series study, Winge et al. studied Ethiopian patients with AD and IV with direct sequencing and ⁄or genotyping for the four common European FLG mutations R501X, 2282del4, S3247X and R2447X. None of the previously described European or Asian mutations were identified. This is not necessarily surprising. The spectrum of FLG mutations varies between different ancestrals. Only the R501X mutation and none of the other common caucasian FLG mutations are represented in the Asian population, which has its own unique spectrum of mutations. However, the authors conclude that FLG mutations are rare in Ethiopia compared with Europe and Asia and suggest other mechanisms as causative for the barrier impairment in Ethiopian individuals with AD. Other mechanisms besides FLG mutations may very well contribute to the pathogenesis of AD in the African population, and speculations concerning the high prevalence of a few FLG mutations in the European population and a wider spectrum in the Asian population vs. a rare occurrence in the African population are multiple: an evolutionary bottleneck in Europe, a constant mutation pressure in Asia, a heterozygous advantage in Europe such as in sickle-cell anaemia and the resilience against malaria infection and in contrast a reduced environmental pressure in Asia resulting in a decline in frequency of disadvantagous alleles. As the authors suggest, FLG mutations may also be disadvantagous in Africa as FLG degradation products serve as substrates for urocanic acid: an ultraviolet-absorbing substance in the stratum corneum. However, it is premature to rule out that a unique spectrum of FLG mutations exists in the African population based on the number of individuals examined and the genetic diversity in native Africans. Indeed one novel mutation was found, and the FLG gene was only fully sequenced in 36% of the individuals studied with the consequent possibility of an underestimation of the FLG mutation prevalence. Other novel mutations may exist and this issue can only be addressed with full sequencing of the FLG gene in a larger number of African individuals. The study by Winge et al. is highly relevant and the first solid attempt to explore and map FLG mutations in the African population. Even though some limitations are present, appropriately recognized by the authors, the study is an important contribution to the global FLG mutation mapping.

British Journal of Dermatology, 2009

Background It is not known if reduced elicitation thresholds are evident among polysensitized ind... more Background It is not known if reduced elicitation thresholds are evident among polysensitized individuals when using allergens to which the patients are already sensitized. Reduced elicitation thresholds may be an expression of increased reactivity in this patient group. Objectives To examine and compare elicitation dose-response curves and elicitation thresholds in a polysensitized vs. a single ⁄double-sensitized group for allergens to which the test subjects were already sensitized. Patients ⁄methods Fifty-one patients (13 polysensitized and 38 single ⁄double-sensitized) were patch tested with nickel sulphate, methyldibromo glutaronitrile (MDBGN) and p-phenylenediamine (PPD) in dilution series. The ratio between the doses eliciting a response in 50% of patients in the two groups was used as the measure for relative sensitivity. Results The dose-response curves of the polysensitized group for MDBGN and PPD were shifted to the right, and for nickel sulphate shifted to the left, compared with the single ⁄double-sensitized group. The relative sensitivity for each of the three allergens and a combined relative sensitivity for all three allergens were not significantly different when comparing the polysensitized and single ⁄doublesensitized groups. Conclusion No increased sensitivity, in the form of distinct elicitation thresholds, could be demonstrated in polysensitized individuals compared with individuals with one or two contact allergies.

Springer eBooks, Aug 12, 2010

Journal of Investigative Dermatology, Jun 1, 2016

UDPglucose activates P2Y14 receptor and induces signal transducer and activator of transcription ... more UDPglucose activates P2Y14 receptor and induces signal transducer and activator of transcription 3 (STAT3) Tyr705 phosphorylation and binding to hyaluronan synthase 2 (HAS2) promoter, stimulating hyaluronan synthesis of keratinocytes. J Biol Chem 2014;289:18569e81. Kono H, Chen CJ, Ontiveros F, Rock KL. Uric acid promotes an acute inflammatory response to sterile cell death in mice.

Journal of the European Academy of Dermatology and Venereology, 2018

BackgroundAtopic dermatitis (AD) is characterized by skin barrier dysfunction. Notably, a high nu... more BackgroundAtopic dermatitis (AD) is characterized by skin barrier dysfunction. Notably, a high number of nano‐scale protrusions on the surface of corneocytes, which can be expressed by the Dermal Texture Index (DTI), were recently associated with paediatric AD, loss‐of‐function mutations in filaggrin gene (FLG) and reduced levels of natural moisturizing factors (NMF). No study has so far examined the association between these parameters and monomeric filaggrin levels in adults.ObjectiveTo determine DTI, monomeric filaggrin and NMF in healthy controls and a group of patients with controlled dermatitis.MethodsA total of 67 adults (20 healthy controls and 47 dermatitis patients) were included. In the patient population, a personal history of AD was diagnosed by the U.K. Working Party's Diagnostic Criteria. All participants were tested for FLG mutations (R501X, 2282del4, R2447X). Transepidermal water loss, monomeric filaggrin, DTI and NMF were measured.ResultsIn the patient populati...

Dermatitis, May 1, 2011

... A 23‐year‐old man presented with AD on the arms, chest, and back and with IV on the areas of ... more ... A 23‐year‐old man presented with AD on the arms, chest, and back and with IV on the areas of the back and chest that were not affected by AD. The patient was a professional windsurfer and wore a neoprene wet suit almost every day. ... Douglas L. Powell, MD. ...

International journal of veterinary medicine, Mar 31, 2013

Tinea infections are very common skin disorders caused by dermatophytes that have the unique abil... more Tinea infections are very common skin disorders caused by dermatophytes that have the unique ability to invade tissue containing keratin. The specific aetiological agents vary geographically related to environmental and cultural factors. The commonest causes of tinea infections in Europe include Trichophyton rubrum, mentagrophytes et verrucosum and Epidermophyton floccosum. The typical dermatophytes responsible for tinea pedis are Trichophyton rubrum et mentagrophytes and Epidermophyton floccosum. We here present a case of tinea pedis with an unusual aetiological pathogen: Trichophyton tonsurans.

Contact Dermatitis, Jun 14, 2010

Background: It is uncertain whether polysensitized patients acquire multiple allergies only becau... more Background: It is uncertain whether polysensitized patients acquire multiple allergies only because of a high degree of exposure to environmental allergens, or because of being highly susceptible to developing contact allergy. Objectives: The aim of this study was to investigate and compare susceptibility and reactivity in polysensitized and monosensitized individuals, and in healthy controls. Patients/methods: We sensitized 66 adult individuals (21 polysensitized, 22 monosensitized, and 23 healthy controls) with diphenylcyclopropenone and assessed challenge responses with visual scoring and ultrasound. We compared sensitization rates using a chi-square test and logistic regression analyses, and calculated linear regression lines of the elicitation responses for each individual. The mean values of the slopes and the intercepts for each group were used to measure the strength of the elicitation response, and were compared using the Mann-Whitney test. Results: Sensitization ratio was equal in the three groups: 57% for the polysensitized, 59% for the monosensitized, and 65% for the healthy control group. There was a lowered elicitation threshold in the polysensitized group compared with that in the monosensitized and healthy control groups and, although not statistically significant, a stronger elicitation response was observed in the polysensitized group. Conclusion: Increased reactivity was found in the polysensitized group, demonstrated by a lowered elicitation threshold, compared with that in the monosensitized and healthy control groups.

Lasers in Surgery and Medicine, 2016

Background and Objectives: Pulsed dye laser (PDL) represents the gold-standard treatment for port... more Background and Objectives: Pulsed dye laser (PDL) represents the gold-standard treatment for port wine stains (PWS). However, approximately 20% of patients are poor responders and yield unsatisfactory end-results. The Alexandrite (Alex) laser may be a therapeutic alternative for selected PWS subgroups, but optimal laser parameters are not known. The aim of this study was to assess clinical PWS clearance and safety of Alex laser at a range of pulse durations. Materials and Methods: Sixteen individuals (14 previously PDL-treated) with deep red (n ¼ 4), purple macular (n ¼ 5) and purple hypertrophic (n ¼ 7) PWS were included. Four side-by-side test areas were marked within each lesion. Three test areas were randomized to Alex laser at pulse durations of 3, 5, or 10 ms (8 mm spot, DCD 60/40), while the fourth was untreated. The lowest effective fluence to create purpura within the entire test spot was titrated and applied to intervention areas. Standardized clinical photographs were taken prior to, immediately after laser exposure and at 6-8 weeks follow up. Clinical PWS clearance and laser-related side effects were assessed using clinical photos. Results: Alex laser at 3, 5, and 10 ms pulse durations demonstrated significant clearance compared to untreated controls (P < 0.001). Three milli second pulse duration exhibited improved clearance versus 5 ms (P ¼ 0.016) and 10 ms (P ¼ 0.004), while no difference between five and 10 ms was shown (P ¼ 0.063). Though not significant, good responders (>50% clearance) were more likely to have purple hypertrophic PWS (5/7) compared to purple macular (2/5) and deep red lesions (1/4). Eight laser-exposed test areas (17%) developed hypopigmented atrophic scarring. Side effects tended to be more frequently observed with 5 ms (n ¼ 4) and 10 ms (n ¼ 3) versus 3 ms pulse duration (n ¼ 1). Correspondingly, 3 ms was associated with a superior (n ¼ 6) or comparable (n ¼ 10) overall cosmetic appearance for all individuals. Conclusion: Alex laser at 3 ms pulse duration offers superior clinical clearance and safety compared to 5 and 10 ms, and seems best suited for purple hypertrophic PWS. Treatment should be restricted to experienced personnel due to a particularly narrow therapeutic window. Lasers Surg. Med.

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Ugeskrift for laeger, Jan 25, 2016

Filaggrin, 2014

The improved understanding of the filaggrin pathway and the secondary and tertiary consequences o... more The improved understanding of the filaggrin pathway and the secondary and tertiary consequences of dysfunction on skin barrier homeostasis have revealed several potential targets for future novel treatments. Superior to them all is enhancement or replacement of the missing components pro-filaggrin, filaggrin, and natural moisturizing factors. A large spectrum of cutaneous and non-cutaneous diseases is associated with the filaggrin gene (FLG) mutations, which hold potential for wide applicability for any new drug targeting filaggrin or other parts of the filaggrin cascade. There are reasons to be optimistic that such drugs can be used both to control disease and also for primary prevention. Non-pharmacological intervention should be directed against minimizing or avoiding exposure to environmental dangers known to deteriorate the skin barrier or cause secondary disease, which may have detrimental effects on already vulnerable skin.

Journal of Allergy and Clinical Immunology, 2012

The mechanisms underlying the association between filaggrin (FLG) deficiency and asthma are not k... more The mechanisms underlying the association between filaggrin (FLG) deficiency and asthma are not known. It has been hypothesized that FLG deficiency leads to enhanced percutaneous exposure to environmental substances that might trigger immune responses. We hypothesized that interactions between FLG deficiency and environmental exposures play a role in asthma development. We sought to investigate possible interactions between FLG null mutations and tobacco smoking in relation to asthma. A total of 3471 adults from a general population sample participated in a health examination. Lung function and serum specific IgE levels to inhalant allergens were measured, and information on asthma and smoking was obtained by means of questionnaire. Participants were genotyped for the 2 most common FLG null mutations in white subjects: R501X and 2282del4. Another Danish population was used for replication. The FLG null mutation genotype was significantly associated with a higher prevalence of asthma and decreased FEV(1)/forced vital capacity ratio. In logistic regression analyses with asthma as the outcome, a significant interaction was found between FLG null mutations and smoking status (P = .02). This interaction was confirmed, although it was not statistically significant, in another Danish population study. Interactions between FLG genotype and cumulated smoking exposure were found in relation to asthma (P = .03) and decreased FEV(1)/forced vital capacity ratio (P = .03). A 3-way interaction was found among FLG genotype, smoking, and asthma, suggesting that the FLG-smoking interaction mainly played a role in nonatopic subjects. FLG null mutations modified the effects of smoking on the risk of asthma. This finding might have implications for risk stratification of the population.

International Archives of Allergy and Immunology, 2013

Background: Loss-of-function mutations of the filaggrin (FLG) gene cause an impaired skin barrier... more Background: Loss-of-function mutations of the filaggrin (FLG) gene cause an impaired skin barrier and increase the risk of atopic dermatitis. Interestingly, FLG mutations have also been found to be associated with a high risk of peanut allergy. Objective: We investigated the association of FLG mutations with self-reported food allergy, symptoms of oral allergy syndrome (OAS), and alcohol sensitivity. Methods: A total of 3,471 adults from the general population participated in a health examination. Information on food allergies, OAS and alcohol sensitivity was obtained by questionnaire. FLG mutation carriers were defined as having at least one null mutation allele of R501X or 2282del4. Primary lactose intolerance (PLI) was defined as the C/C genotype of the rs4988235 polymorphism. Results: FLG mutations were associated with a higher risk of self-reported allergy to eggs (OR 3.22 and 95% CI 1.46-7.11), milk (OR 2.10 and 95% CI 1.12-3.92), fish (OR 4.54 and 95% CI 1.88-10.96) and wheat...

Environmental Health Perspectives, 2013

Purpose: Filaggrin proteins are expressed in the skin, oral cavity, oesophagus, and cervical muco... more Purpose: Filaggrin proteins are expressed in the skin, oral cavity, oesophagus, and cervical mucose. Loss-of-function mutations in the filaggrin gene (FLG) reduce filaggrin expression and cause an impaired skin barrier function. We hypothesized that FLG mutation carriers would be more susceptible to human papillomavirus (HPV) infection and thus a higher risk of HPV-related cancer and pre-cancer. We investigated the association of the FLG genotype with incidence of HPV-related cancer of cervix, vagina, vulva, penis, anus and head and neck, and pre-cancer of the cervix. Methods: We included 13,376 persons from four population-based studies conducted in the same background population in Copenhagen, Denmark. Participants were genotyped for the most common FLG mutations in Europeans. Information on cancer was obtained from The Danish Cancer Registry until 11 July 2011. Results: There were 489 cases of prevalent and 97 cases of incident HPV-related cancer and pre-cancer (median follow-up 11.5 years). There was a statistically significant association between FLG genotype and incident HPV-related cancer and precancer with a hazard ratio, HR = 2.1 (95% confidence intervals, CI: 1.2, 3.7) for FLG mutation carriers vs. wild types. Conclusions: FLG loss-of-function mutations were associated with higher incidence of HPV-related cancers and pre-cancers that are potentially screening and vaccine preventable.

Contact Dermatitis, 2010

Background: Filaggrin null (FLG) mutations lead to skin barrier disruption with a reduced resista... more Background: Filaggrin null (FLG) mutations lead to skin barrier disruption with a reduced resistance towards exogenous agents and also influence the course of disease in atopic dermatitis. Objectives: To examine the association between FLG mutations and contact allergy, polysensitization, hand eczema at first appearance of disease, occurrence, and course of dermatitis. Methods: A venous blood sample from 430 individuals was genotyped for FLG mutations R501X and 2282del4 with polymerase chain reaction followed by typing through hybridization to paramagnetic polystyrene beads and analysis on a BioPlex 200. All individuals had a minimum of one positive patch test reaction. Results: In all, 3.5% were 2282del4 heterozygote and 5.1% were R501X heterozygote. An odds ratio (OR) of 1.49 [95% confidence interval (CI) 0.74-3.00] was found for nickel allergy, OR 0.84 (95% CI 0.41-1.74) for polysensitization, OR 0.78 (95% CI 0.25-2.43) for dermatitis, OR 0.96 (95% CI 0.48-1.92) for hand eczema at debut, OR 1.25 (95% CI 0.99-1.57) for duration of disease, and OR 0.76 (95% CI 0.59-0.97) for age at onset. Conclusions: No association between nickel allergy, polysensitization, hand eczema at first appearance or occurrence of dermatitis, and FLG mutations was found. However, patients with FLG mutations had an earlier age of onset compared with the wild-type genotype and a trend towards longer duration of disease.

British Journal of Dermatology, 2010

Filaggrin null mutations increase the risk and persistence of hand eczema in subjects with atopic... more Filaggrin null mutations increase the risk and persistence of hand eczema in subjects with atopic dermatitis: results from a general population study This study investigated the association between hand eczema and filaggrin null mutations. In total, 3335 adults were questioned, patch tested and genotyped for the two most common filaggrin null mutations R501X and 2282del4. Logistic regression analyses revealed positive associations between hand eczema within the past 12 months and filaggrin null mutation status in participants with a history of atopic dermatitis (AD) [odds ratio (OR) 2.98; 95% confidence interval (CI) 1.27-7.01], but not in subjects without AD (OR 0.82; 95% CI 0.41-1.67). Subjects with combined AD and filaggrin null mutation had an earlier onset, a higher persistence of hand eczema, and a higher frequency of contact allergy (17.9% vs. 9.4%) compared with subjects with normal filaggrin status and without AD.