Clinical and Experimental Dermatology最新文献

{"title":"Recurrences and rechallenges of suspected drugs in patients with epidermal necrolysis.","authors":"Thomas Bettuzzi, Bénédicte Lebrun-Vignes, Haudrey Assier, Laura Pina Vegas, Saskia Ingen-Housz-Oro, Emilie Sbidian","doi":"10.1093/ced/llae553","DOIUrl":"10.1093/ced/llae553","url":null,"abstract":"<p><strong>Background: </strong>Epidermal necrolysis (EN) is a rare and severe condition characterized by diffuse skin and mucosal detachment and mainly induced by drugs. The literature is scarce regarding the rate of recurrences and culprit drug re-exposure.</p><p><strong>Objectives: </strong>To assess the rate of EN recurrences and to examine re-exposure to high-notoriety drugs in patients with EN.</p><p><strong>Methods: </strong>We used the French health system database and included all patients with EN. Suspected drugs were assessed at the onset of EN. The primary outcome was the rate of EN recurrence. Secondary outcomes were re-exposure or cross-exposure to high-notoriety drugs (exposure to a drug of the same family) after the acute stage of EN.</p><p><strong>Results: </strong>In total, 1203 of 1440 patients (83.5%) survived the acute stage, with 27 patients (2.2%, 95% confidence interval 1.5-3.2) meeting the recurrence criteria. In patients with allopurinol as the suspected drug, 10 of 77 (13%) were cross-exposed to febuxostat, without recurrence. Similarly, in patients with carbamazepine or oxcarbazepine as the suspected drug, 2 of 26 (8%) were cross-exposed to lamotrigine, without recurrence. Conversely, 12 of 38 (32%) and 16 of 37 (43%) patients were respectively re-exposed to pantoprazole and esomeprazole when initially suspected, and 12 of 42 (29%) were re-exposed to amoxicillin. Only one recurrence was noted in a patient re-exposed to pantoprazole.</p><p><strong>Conclusions: </strong>Among patients with EN, the rate of recurrence seems low, contrasting with several re-exposures to beta-lactam antibiotics and proton pump inhibitors when initially suspected. Although we cannot exclude that the suspected drugs were not the responsible ones for several patients, future studies should assess the possible existence of transient risk factors inducing EN.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1116-1124"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930727","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}

{"title":"'I don't worry about going outside anymore': a patient's journey with recalcitrant lupus pernio responsive to adalimumab.","authors":"Eimear Duff, Cliona Feighery","doi":"10.1093/ced/llaf027","DOIUrl":"10.1093/ced/llaf027","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1256-1257"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000813","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}

{"title":"The recent change in the British National Formulary topical corticosteroid potency classification is not evidence-based.","authors":"Andrew Affleck, Robert Dawe, Joerg Albrecht","doi":"10.1093/ced/llaf049","DOIUrl":"10.1093/ced/llaf049","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1240-1241"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064194","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}

{"title":"Clinical predictors of disease severity in oral lichen planus.","authors":"Sreedevi P Unnikrishnan, Janice Boggon, Bernice Mclaughlin, Maggie E Cruickshank, Rasha Abu-Eid, Karolin Hijazi","doi":"10.1093/ced/llae558","DOIUrl":"10.1093/ced/llae558","url":null,"abstract":"<p><strong>Background: </strong>The limited understanding of factors influencing the disease progression of oral lichen planus (OLP) poses challenges in delivering effective and personalized treatment for this condition, known to increase the risk of oral cancer and have an adverse impact on patients' quality of life.</p><p><strong>Objectives: </strong>To systematically identify clinical predictors of disease severity in patients with OLP.</p><p><strong>Methods: </strong>This cross-sectional and single-site prospective study was conducted between December 2021 and February 2024 in the Departments of Oral Medicine and Oral & Maxillofacial Surgery (Aberdeen Royal Infirmary, Aberdeen, UK). Patients presenting with OLP aged 18 years or older diagnosed using Van der Meij and Van der Waal criteria were eligible for the study. Out of a total of 270 eligible patients with OLP presenting consecutively to the outpatient clinics during the study period, 89 patients agreed to participate and were enrolled into the study. Participants demographic and relevant clinical data, namely medical history, smoking status, alcohol consumption, perceived stress levels, oral hygiene status and haematological and biochemical parameters, including full blood count, haematinics and vitamin D, were recorded. The outcome measure was OLP disease severity measured as the Oral Disease Severity Score (ODSS), Gingival ODSS and the Reticular/hyperkeratotic, Erosive/erythematous, Ulcerative (REU scoring system).</p><p><strong>Results: </strong>In total, 89 participants were recruited into the study. The median age of the study population was 66 (interquartile range 58-73) years, and 65 (73%) patients were women. The median total ODSS score was 10 (range 0-44). After adjustment for confounding factors, patients with lichen planus affecting skin or other mucosal sites had a 5.76-unit higher OLP severity score [B = 5.76, 95% confidence interval (CI) = 0.74-10.78, P = 0.03] than those without extraoral involvement as measured by the ODSS. Patients with insufficient vitamin D exhibited a 5.49-unit increase in disease severity (B = 5.49, 95% CI = 1.13-9.84, P = 0.01) compared with those with adequate vitamin D levels.</p><p><strong>Conclusions: </strong>This study identified the importance of cutaneous and/or genital lichen planus in phenotyping OLP disease severity. We also highlight the role of vitamin D as a significant predictor of disease severity of OLP, suggesting the importance of adequate vitamin D levels in patient management.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1146-1154"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920895","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}

{"title":"Comment on 'Modified intralesional aciclovir therapy in the management of recalcitrant palmoplantar and ungual warts: a case series of 14 patients'.","authors":"Nihal Altunisik, Zekiye Kanat, Suat Sezer, Dursun Turkmen","doi":"10.1093/ced/llaf032","DOIUrl":"10.1093/ced/llaf032","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1214"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000863","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}

{"title":"General dermatology and dermatology in primary healthcare.","authors":"Ahmet Taha Aydemir, Ayse Boyvat, Bengu Nisa Akay","doi":"10.1093/ced/llaf025","DOIUrl":"10.1093/ced/llaf025","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1262-1264"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001008","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}

{"title":"Progressive limb hardening in a young woman.","authors":"Wei-Yao Wang, Chieh-Hsun Chen","doi":"10.1093/ced/llaf037","DOIUrl":"10.1093/ced/llaf037","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1281-1284"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001029","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}

{"title":"Novel microsatellite instability test of sebaceous tumours to facilitate low-cost universal screening for Lynch syndrome.","authors":"Richard Gallon, Georgie Holt, Waleed Alfailakawi, Akhtar Husain, Claire Jones, Peter Sowter, Mauro Santibanez-Koref, Michael S Jackson, John Burn, Sam Cook, Neil Rajan","doi":"10.1093/ced/llaf005","DOIUrl":"10.1093/ced/llaf005","url":null,"abstract":"<p><strong>Background: </strong>One in five patients with sebaceous tumours (STs) may have Lynch syndrome (LS), an inherited disorder that increases the risk of developing cancer. Patients with LS benefit from cancer surveillance and prevention programmes and immunotherapy. While universal tumour mismatch repair (MMR) deficiency testing is recommended in colorectal and endometrial cancers to screen for LS, there is no consensus screening strategy for STs, leading to low testing rates and inequity of care.</p><p><strong>Objectives: </strong>To assess a low-cost and scalable sequencing-based microsatellite instability (MSI) assay, previously shown to enhance LS screening of colorectal cancers, for MMR deficiency detection in STs against the current clinical standard of immunohistochemistry (IHC).</p><p><strong>Methods: </strong>Consecutive ST cases (n = 107) were identified from the records of a single pathology department. MMR protein IHC staining was interpreted by a consultant histopathologist. MSI analysis used amplicon sequencing of 14 microsatellites and a naive Bayesian classifier to calculate the sample MSI score.</p><p><strong>Results: </strong>Loss of MMR protein expression was observed in 49/104 STs with interpretable IHC [47.1%, 95% confidence interval (CI) 37.3-57.2]. MMR deficiency was less frequent in carcinoma than in adenoma and sebaceoma (P = 4.74 × 10-3). The majority of MMR-deficient STs had concurrent loss of MSH2 and MSH6 expression. The MSI score achieved a receiver operator characteristic area under curve of 0.944 relative to IHC. Lower MSI scores were associated with MSH6 deficiency.</p><p><strong>Conclusions: </strong>These data support MSI testing as an adjunct or alternative to MMR IHC in STs. Integration of STs into established LS screening pathways using this high-throughput methodology could increase testing and reduce costs.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1155-1162"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence trends in paediatric psoriasis 1990-2021: findings from the Global Burden of Disease Study 2021.","authors":"Ling Jin, Jingyi Yang, Pengjie Wan, Ying Cheng","doi":"10.1093/ced/llaf050","DOIUrl":"10.1093/ced/llaf050","url":null,"abstract":"<p><strong>Background: </strong>Paediatric psoriasis is a chronic inflammatory skin disease that poses unique challenges in diagnosis and management. While studies from high-income countries have reported increasing trends in incidence, data regarding the incidence of paediatric psoriasis worldwide remain scarce.</p><p><strong>Objective: </strong>To provide a comprehensive description of the incidence of paediatric psoriasis at the global, regional and national levels.</p><p><strong>Methods: </strong>We used data from the Global Burden of Disease Study 2021 to analyse trends in the incidence of paediatric psoriasis between 1990 and 2021. Incidence rates were stratified by age, sex and sociodemographic index (SDI). The estimated annual percentage change (EAPC) was used to quantify the temporal trends.</p><p><strong>Results: </strong>In 2021, there were 664 100 cases of paediatric psoriasis globally, with an incidence rate of 33.0 per 100 000 children. Over the study period, the global incidence increased by 0.21% (95% confidence interval 0.18-0.25%) per year, with more pronounced increases observed in regions categorized as low SDI and middle SDI. The highest incidence rates were recorded in regions categorized as high SDI, such as High-income North America (70.5 per 100 000) and Western Europe (67.5 per 100 000). Notably, the largest increases in incidence occurred in regions such as sub-Saharan Africa. At the national level, 189 countries/territories experienced significant increases in the incidence of paediatric psoriasis, while only 5 countries saw a decline. Incidence was higher in girls across all age groups, and the most pronounced increase was seen in children aged less than 5 years.</p><p><strong>Conclusions: </strong>The incidence of paediatric psoriasis has increased significantly in recent years, particularly in regions categorized as low SDI and middle SDI, underscoring the need for improved diagnosis, early intervention and targeted public health strategies.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1171-1179"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064222","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}

{"title":"The impact of COVID-19 on ultraviolet phototherapy services in Scotland.","authors":"Ewan Eadie","doi":"10.1093/ced/llaf063","DOIUrl":"10.1093/ced/llaf063","url":null,"abstract":"","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"1252-1253"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188576","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}