127 TREATGermany registry: “real-world effectiveness” of dupilumab in atopic dermatitis S Weidinger 1 , D Sto ¨lzl 1 , S Abraham 2 , E Haufe 3 , A Heratizadeh 4 , T Werfel 4 and J Schmitt 3 1 Center for Inflammatory Skin Diseases, Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, 2 Department of Dermatology, University Allergy Center, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Ger- many, 3 Center of Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany and 4 Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany Dupilumab has demonstrated therapeutic benefits in clinical trials on adults with moderate- to-severe atopic dermatitis (AD). Evaluation of outcomes in real-world clinical practice is needed to provide a complete understanding of its benefits. Our objective was to investigate the use, effectiveness and safety of dupilumab in routine care. TREATgermany is a prospective registry that collects clinical and molecular data in patients receiving or are eligible for systemic treatments in routine care. Primary effectiveness outcomes were proportion of pa- tients achieving EASI-50 or EASI-75, as well as patient reported outcomes. Between 06/2016 and 01/2019, 612 patients were enrolled by 32 recruitment sites. Since 12/2017, when Dupilumab was launched, 174 of 195 patients of TREATgermany receiving a new systemic therapy within routine care were prescribed dupilumab. Dupilumab was effective in all outcome domains investigated after 12 weeks: EASI 74.2%, POEM 54.5%, DLQI 64.7% (mean percent change). EASI-50, EASI-75, and EASI-90 response-rates were 77.1%, 57.1%, and 25.7%, respectively. Factors associated with response included younger age and more severe AD. Concurrent topical treatments were substantially reduced during Dupilumab therapy. Response rates were stable until week 24. Dupilumab was rapidly introduced in routine care in Germany and emerged as first line therapy. Response rates were comparable to those observed in clinical trials. 128 Measurement of galactose-alpha-1,3-galactose-related specific IgE before the first administration of cetuximab can reduce the incidence of cetuximab-induced anaphylactic shock Y Chinuki 1 , K Ito 2 and E Morita 1 1 Dermatology, Shimane University Faculty of Medicine, Izumo, Japan and 2 Otorhinolaryngology-Head and Neck Surgery, Matsue Red Cross Hos- pital, Matsue, Japan It is known that the main causative antigenic epitope of cetuximab allergy is galactose-alpha- 1,3-galactose (alpha-Gal). In 2013, 13 patients with head and neck cancer received the first administration of cetuximab at Matsue Red Cross Hospital in the western part of Japan, and fourof them developed anaphylactic shock (Incidence rate was 31%). In the sera of these patients, both alpha-Gal specific IgE by CAP-FEIA and cetuximab specific IgE by western blotting were detected. Both sensitivity and specificity in 13 patients of these tests were 100%. We therefore aimed to prevent cetuximab-induced anaphylactic shock by performing these tests before the administration. We measured alpha-Gal specific IgE by CAP-FEIA and cetuximab specific IgE by western blotting before the first administration of cetuximab in 206 patients with head and neck cancer, and gave the first dose of cetuximab to the patients who showed either on these two tests. As a result, alpha-Gal-specific IgE was detected in 15 of 206, and cetuximab-specific IgE was detected in 12 of 206. Nine patients showed positive on both tests. Thirty nine of the 188 patients who showed negative either on these two tests have received cetuximab so far, and two of them developed anaphylactic shock (Incidence rate was 5%). Although the incidence rate did not reach to 0%, cetuximab-induced anaphylactic shock could be significantly reduced by prior measurement of alpha-Gal-related specific IgE. The reason why the incidence rate could not be 0% may be because the cutoff value (<0.35 kU A /L) we decided was high. 129 Detection of high-risk human papillomavirus in nail squamous cell carcinoma and comprehensive analyses of 136 cases from the literature: The implications for high-risk human papillomavirus reservoir and sexually transmitted infection A Shimizu, Y Kuriyama, S Mizuno and O Ishikawa Dermatology, Gunma University, Mae- bashi, Japan Squamous cell carcinoma (SCC) in the genital region is recognized to be caused by human papillomavirus (HPV) infection. Although SCC of the nail apparatus have been reported to be associated with high-risk HPVs, this fact is not widely known in general medicine, and sys- temic analyses have not been performed. The purpose of this study was to clarify the HPV infection in the nail apparatus in our department and summarize previous data from the literature. We collected 106 samples of SCC/SCC in situ and performed polymerase chain reaction using HPV consensus primers and subsequent direct DNA sequencing. We per- formed immunohistochemistry (IHC) using an anti-HPV antibody. We also reviewed 136 cases of HPV-associated nail SCC/SCC in situ in the literature in order to reveal the clinical characteristics. Two cases of genital SCC and 9 cases of SCC in situ were high-risk HPV positive. Of note, 6 HPV-positive cases were nail SCC in situ. In those cases, numerous HPV- positive cells were observed around the nail fold, especially in the nail matrix. HPV-positive cells are distributed even in the proximal nail fold, suggesting that the HPV infection spreads beyond the clinically visible lesion. On reviewing the previous literature of nail SCC, the patients’ ages ranged from 12 to 85 years old (average age 52.2 years old), and the sex ratio was 2.3:1 (92 males and 39 females). About half of cases were positive for high-risk HPV. The disease had male dominance, and left digit 3 and right digits 1-3 were frequently affected. Multiple lesions were seen in 11 patients. In this review, 24% of the cases of nail SCC had a history of other HPV-associated diseases, suggesting the possibility of genito-digital trans- mission. In this study, we showed that the nail apparatus is a characteristic region for high-risk HPV infection. Based on this analysis, we propose that nail SCC is a high-risk HPV-associated reservoir site for sexually transmitted infection. 130 Chronic Inflammatory Skin Diseases are Associated with Herpes Zoster in US Inpatients R Chovatiya and J Silverberg Northwestern University, Chicago, IL Herpes zoster (HZ) is a vaccine-preventable, viral eruption that affects 1 of every 3 people in the US in their lifetime. Patients with chronic inflammatory skin diseases (CISDs) have po- tential risk factors for HZ, including chronic immunosuppressant use and immune dysregu- lation. We sought to determine whether CISDs are associated with HZ in hospitalized patients in the US. Data were analyzed from the 2002-2012 Nationwide Inpatient Sample, a repre- sentative 20% cross-sectional cohort of US hospitalizations (N¼68,490,364 children and adults). In multivariable weighted logistic regression models including age, sex, race/ ethnicity, insurance, income, and long-term systemic corticosteroid use, primary hospitali- zation for HZ was associated with multiple CISDs: atopic dermatitis (adjusted odds ratio [95% confidence interval]: 3.19 [1.94-5.28]), psoriasis (1.37 [1.13-1.67]), pemphigus (4.76 [2.82- 8.04]), mycosis fungoides (3.82 [2.56-5.69]), dermatomyositis (7.50 [5.44-10.35]), systemic sclerosis (1.91 [1.46-2.51]), cutaneous lupus erythematosus (1.93 [1.09-3.41]), vitiligo (1.98 [1.03-3.83]), and sarcoidosis (1.50 [1.20-1.88]. Other CISDs showed higher odds only in bivariable models: bullous pemphigoid (2.76 [1.69-4.51]), lichen planus (2.97 [1.34-6.59]), morphea (2.76 [1.39-5.49]), pyoderma gangrenosum (2.45 [1.16-5.15]), and Se ´zary syn- drome (12.11 [5.19-28.26]). Whereas, chronic idiopathic urticaria and hidradenitis suppu- rativa were not associated with HZ. Similar results were seen among patients of age <50 years. Significant predictors of primary hospitalization for HZ among patients with CISDs included older age, female sex, non-white race/ethnicity, and long-term systemic cortico- steroid use. Length of stay and/or cost of care were significantly higher in inpatients with CISDs with vs. without a primary diagnosis of HZ. CISDs are associated with increased hospitalization for HZ. Further studies are needed to confirm these associations, determine their mechanisms, and optimize vaccination. Patients with CISDs constitute a significant, previously under-recognized group that is high-risk for hospitalization for HZ. 131 Phase I/II efficacy and safety study of mesenchymal stromal cells in recessive dystrophic epidermolysis bullosa L Martı ´nez-Santamarı ´a 1 , R Maseda 2 , M Garcı ´a 1 , E Chaco ´ n-Solano 1 , S Garcı ´a-Barcenilla 3 , SM Lwin 4 , JA McGrath 4 , M del Rı ´o 1 , R de Lucas 2 and M Esca ´mez 1 1 Bioengineering Department, Carlos III University (UC3M-CIEMAT-IISFJD-CIBERER), Madrid, Spain, 2 Dermatology Department, La Paz University Hospital, Madrid, Spain, 3 Hematology Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain and 4 St John’s Institute of Dermatology, King’s College London, London, United Kingdom Patients with Recessive Dystrophic Epidermolysis Bullosa (RDEB) have a pronounced muco- cutaneous fragility, which triggers the formation of blisters spontaneously or in response to minimal trauma. RDEB is also associated with chronic inflammation; patients have wounds that do not close and aggressive squamous cell carcinomas. The disease is due to mutations in the COL7A1 gene that codifies for collagen VII (C7). One of the most promising therapeutic options is the use of mesenchymal stromal cells (MSCs) from healthy donors that, in addition to producing C7 and having anti-inflammatory properties, are well tolerated by the patient’s immune system. When administered systemically, they could display their anti-inflammatory potential in the skin and mucous membranes, modulate the behavior of the cells involved in healing, stimulate tissue remodeling, reduce fibrosis and, perhaps, improve dermo-epidermal adhesion. Transient beneficial effects of the systemic use of MSCs have been reported in the treatment of patients with RDEB. For this purpose, we are conducting a phase I/II Spanish single-center clinical trial of systemic MSCs therapy, MesenSistem-EB (EudraCT 2017- 000606-37), with 9 pediatric patients with RDEB. MesenSistem-EB has been designed to evaluate the safety and preliminary efficiency of the systemic administration of MSCs derived from haploidentical bone marrow donors. Understanding the molecular mechanisms by which these cells exert their action will contribute to optimize the treatment and increase the persistence of the therapeutic benefits. We are also carrying out a nested study consisting in a transcriptomic-metabolomic analysis of the patient response to the treatment. 132 Long-wave Medical Infrared Thermography assessment of inflammation in hidradenitis suppurativa/acne inversa CC Zouboulis 1,2 , AN da Costa 3 , GB Jemec 4,2 and D Trebing 1 1 Departments of Dermatology, Venereology, Allergology and Immunology, Brandenburg Medical School Theodor Fontane, Dessau Medical Center, Dessau, Germany, 2 EHSF, Dessau, Germany, 3 Translational Medicine, UCB BioPharma SPRL, Braine L’Alleud, Belgium and 4 Department of Derma- tology, Zealand University Hospital, University of Copenhagen, Roskilde, Denmark A more reliable classification of skin inflammation and severity of active disease results by ultrasound sonography and the new HS classification system IHS4. However, an objective assessment of skin inflammation in a continuous mode is still the ultimate goal. Long-wave Medical Infrared Thermography (MIT) may offer a blood flow and temperature differential assessment in inflammatory conditions. This project was designed to evaluate the application of MIT in HS. Standardised photography of the areas involved or been candidate for HS involvement and MIT pictures of 18 patients [11 female, 7 male, median age 38.75 years (95% confidence intervals 28.5 and 51 years), Hurley score I 5.6%, Hurley score II 38.9% and Hurley score III 55.5%] were taken subsequently with a FLIR T650sc Thermography Imaging Unit at a distance of 50 cm from the skin surface and the pictures were super- imposed. A modification of the Otsu’s method facilitated the automatic lesion segmentation from the background, depicting the inflammation area. Moreover, MIT was administered in real-time mode during radical HS surgery. A 1  C temperature difference from a corresponding symmetric body region was indicative of inflammation. MIT figures detected a gradual in- crease of skin temperature from 33.0  C in healthy skin in average to 35.0-36.6  C at the center of inflammatory lesions in the axilla and to 35.4-36.9  C at the center of inflammation at the groin area. Real-time MIT assessment enabled the definition of the margins and depth of the surgical intervention during the procedure. In conclusion, MIT is a promising tool for detection of inflammation severity in HS lesions and can be used as a clinical biomarker in evaluation studies of medical and surgical HS treatment. ABSTRACTS | Clinical Research and Epidemiology S236 Journal of Investigative Dermatology (2019), Volume 139