Clinical and Experimental Dermatology最新文献_第5页

The National Health Service 2-week-wait skin cancer referral pathway: analysis and recommendations for process improvement. 国家医疗服务系统皮肤癌两周等待转诊路径：分析与流程改进建议》（NHS two week wait skin cancer referral pathway: analysis and recommendations for process improvement）。

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae323

Vishal Madan

{"title":"The National Health Service 2-week-wait skin cancer referral pathway: analysis and recommendations for process improvement.","authors":"Vishal Madan","doi":"10.1093/ced/llae323","DOIUrl":"10.1093/ced/llae323","url":null,"abstract":"Background: Although pressures on the National Health Service skin cancer services pre-dated the COVID pandemic, the 2-week-wait (2WW) skin cancer standards that require hospitals to provide an appointment with a specialist within 2 weeks for anyone with symptoms that may indicate cancer have deteriorated post the pandemic.Objectives: To undertake process mapping of the current 2WW skin cancer pathways and provide recommendations to streamline and improve the pathway to meet the 2WW standards.Methods: The 2WW skin cancer pathway is analysed in this report utilizing 4 V typology encompassing the four dimensions of operations: volume, variety, variation and visibility, and a volume-variety matrix. A performance matrix of the 2WW skin cancer pathway and SIPOC (suppliers, inputs, processes, outputs and customers) analysis are also examined.Results: Process analysis enabled the identification of some of the limitations of the 2WW skin cancer pathway. Following analysis and redesign of the process map of the pathway, recommendations, including lesion assessment using artificial intelligence, single-lesion assessment clinics and direct access skin surgery, all of which aim to expedite patient care and increase capacity in 2WW clinics, are provided.Conclusions: The process analysis of the 2WW skin cancer pathway provides useful insights and helps identify bottlenecks in the system. Recommendations following remapping the process offer potential solutions to help reduce time to referral and to increase capacity. These recommendations should help reduce waiting times for patients receiving an initial diagnosis and subsequent definitive treatment for suspected skin cancers.","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"88-96"},"PeriodicalIF":3.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pachydermoperiostosis: cosmetic implications in a multisystem genetic condition. 蛛网膜下腔出血：多系统遗传病对美容的影响

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae337

James W Dickens, Kian Wah Lim, Matthew Roy, Hannah Wainman

引用次数: 0

Successful treatment of Darier disease with ablative fractional carbon dioxide laser. 用点阵二氧化碳激光成功治疗达里尔-怀特病

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae334

Charlotte Michelmore, Emma Hitchens, Lauraine Johnstone, Daniel Keith

引用次数: 0

Dermatopathology. 皮肤病理学。

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae336

Akshay Meena, Pampa Ch Toi, Swaathi Ramesh, Sheetanshu Kumar

引用次数: 0

Clinical outcomes of the management of basal cell carcinomas in individuals aged 90 years and over: a retrospective cohort study. 90 岁及以上老年人基底细胞癌的临床治疗效果 - 一项回顾性队列研究。

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae344

Isabelle Nicholls, Marc Moncrieff, Martyn Patel, Jenny Nobes, Jennifer Garioch

{"title":"Clinical outcomes of the management of basal cell carcinomas in individuals aged 90 years and over: a retrospective cohort study.","authors":"Isabelle Nicholls, Marc Moncrieff, Martyn Patel, Jenny Nobes, Jennifer Garioch","doi":"10.1093/ced/llae344","DOIUrl":"10.1093/ced/llae344","url":null,"abstract":"Background: A retrospective cohort study was undertaken to examine the management of basal cell carcinoma (BCC) in older patients.Objectives: The aim of this study was to identify subgroups where intervention could be minimized, based on frailty and trends in survival.Methods: All patients aged ≥ 90 years with histologically confirmed BCC during 2017 and 2018 were included within the study (n = 319).Results: Age was the most significant predictor of survival [hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.04-1.17; P = 0.001]. Maximum threshold analysis identified 93 years as the significant age cutpoint. Median survival was 40 months for patients aged ≤ 93 years and 28 months for those aged > 93 years (P = 0.002). Patients with dementia had a worse survival than those without (median survival 25 months vs. 35 months, respectively; HR 1.92, 95% CI 1.18-3.13; P = 0.009). There was a statistically significant difference in survival for patients who received treatment for their BCC (n = 294) compared with the untreated cohort (n = 25) (median survival 34 months vs. 21 months, respectively; HR 0.54, 95% CI 0.34-0.85; P = 0.007). All other comorbidities examined had no influence on survival.Conclusions: This study provides evidence in support of active treatment of BCC in individuals aged ≥ 90 years, seen in secondary care. Conservative options may be preferable in patients with dementia or those > 93 years old.","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"120-124"},"PeriodicalIF":3.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Eruptive telangiectasia: a closer look at trastuzumab emtansine cutaneous complications in patients with breast cancer. 溃疡性毛细血管扩张症：仔细研究乳腺癌患者的曲妥珠单抗-依单抗皮肤并发症。

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae359

Carmen Cánovas Seva, José Sáez Padilla, María López-Pardo Rico, Cecilia Buján Bonino, Carlos Aliste Santos, Noelia Moreiras Arias

引用次数: 0

Efficacy of rituximab in the treatment of epidermolysis bullosa acquisita. 利妥昔单抗治疗获得性表皮松解症的疗效。

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae283

Sosipatros P Bratsos, Zilan Demir, John B Mee, Richard W Groves, Thomas J Tull

{"title":"Efficacy of rituximab in the treatment of epidermolysis bullosa acquisita.","authors":"Sosipatros P Bratsos, Zilan Demir, John B Mee, Richard W Groves, Thomas J Tull","doi":"10.1093/ced/llae283","DOIUrl":"10.1093/ced/llae283","url":null,"abstract":"Background: Epidermolysis bullosa acquisita (EBA) is a chronic mucocutaneous disease that is mediated by antibodies that bind collagen VII. The treatment of EBA can be challenging and the use of multiple immunomodulatory drugs is often required. Rituximab has been reported to be an effective treatment for recalcitrant EBA, although the evidence base for this treatment is limited to case reports and case series.Objectives: This study aimed to evaluate the efficacy of rituximab for the treatment of patients with EBA.Methods: Patients with EBA who were treated with rituximab were identified by searching electronic medical records. The diagnostic criteria for EBA were mechanobullous skin lesions and/or mucosal ulceration, indirect immunofluorescence localizing to the base of salt-split skin, and positive collagen VII antibodies. Clinical disease activity, collagen VII antibody levels and serum immunoglobulin levels were recorded at each follow-up visit over a 600-day period. Treatment responses were classified as follows: complete remission (CR) was defined as the absence of new or established lesions on minimal therapy for 2 months, partial remission (PR) was defined as transient lesions that heal within 1 week on minimal therapy, and active disease was defined as the development of new lesions.Results: In total, 14 patients with EBA were treated with rituximab. CR or PR was observed in 11 patients, and the duration of response varied between 4 and 24 months. A reduction in collagen VII antibody levels was observed in all patients. No significant adverse events were reported.Conclusions: Rituximab is a safe and effective treatment for patients with recalcitrant EBA, although there was significant heterogeneity in the disease response.","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"97-103"},"PeriodicalIF":3.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The utility of interleukin-23 intraclass switching in the treatment of plaque psoriasis: a retrospective review of 43 cases. IL-23类内切换在治疗斑块状银屑病中的效用：对43例病例的回顾性研究。

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae305

M Grace Hren, Sreekar Miriyala, Saakshi Khattri

{"title":"The utility of interleukin-23 intraclass switching in the treatment of plaque psoriasis: a retrospective review of 43 cases.","authors":"M Grace Hren, Sreekar Miriyala, Saakshi Khattri","doi":"10.1093/ced/llae305","DOIUrl":"10.1093/ced/llae305","url":null,"abstract":"Interleukin (IL)-23 inhibitors are a class of injectable biologics, which include risankizumab, tildrakizumab and guselkumab, used for the treatment of moderate-to-severe psoriasis. This retrospective review sought to determine the value of IL-23 inhibitor intraclass switching among patients with psoriasis after they experienced loss of efficacy to any IL-23 inhibitor. We conducted a retrospective chart review, including 43 patients who underwent any of 6 potential iterations of IL-23 intraclass switching between November 2017 and November 2023. Most commonly, patients switched from guselkumab or tildrakizumab to risankizumab (84%). On average, patients failed 2.3 biologic treatments (SD 1.3) prior to switching. Postswitching, 81% of patients achieved an affected body surface area (BSA) < 1% after 248.8 days (SD 126.5). BSA immediately prior to intraclass switch was 13.1 (SD 8.9) [95% confidence interval (CI) 10.4-15.8] and at most recent follow-up was 2.9 (SD 5.2) (95% CI 2.3-5.5). This research adds to a growing body of literature demonstrating the potential of IL-23 intraclass switching in the treatment of moderate-to-severe plaque psoriasis.","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"137-140"},"PeriodicalIF":3.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bullous drug eruption. 大疱性药疹

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae294

Dora Mancha, Cláudia Brazão, Lanyu Sun, João Pedro de Vasconcelos, Teresa Correia, Luís Soares-de-Almeida, Paulo Filipe

引用次数: 0

Cosmetic benefit in Mohs surgery: an overemphasized theme? 莫氏手术的美容效果--一个被过分强调的主题？

IF 3.7 4区医学

Clinical and Experimental Dermatology Pub Date : 2024-12-23 DOI: 10.1093/ced/llae327

Sibel Demirel, Andrew Affleck

引用次数: 0