Current Dermatology Reports最新文献

{"title":"Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin.","authors":"Rhea Singh,&nbsp;Esther E Freeman","doi":"10.1007/s13671-022-00370-9","DOIUrl":"https://doi.org/10.1007/s13671-022-00370-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review aims to evaluate the spectrum of cutaneous reactions after both SARS-CoV-2 infection and COVID-19 vaccination while simultaneously understanding the evolution of the field of dermatology in the face of an ongoing pandemic.</p><p><strong>Recent findings: </strong>The most commonly reported cutaneous reactions after COVID-19 infection in the literature to date include morbilliform or maculopapular rashes, chilblains, and urticaria. The incidence of cutaneous reactions after COVID-19 vaccination was 9% in larger cohort studies and more commonly occurred after mRNA-based COVID-19 vaccines than adenovirus vector vaccines. The most frequently reported cutaneous reactions after COVID-19 vaccines were delayed large local reactions, local injection site reactions, urticarial eruptions, and morbilliform eruptions.</p><p><strong>Summary: </strong>With the ongoing pandemic, and continued development of new COVID-19 variants and vaccines, the landscape of cutaneous reactions continues to rapidly evolve. Dermatologists have an important role in evaluating skin manifestations of the virus, as well as discussion and promoting COVID-19 vaccination for their patients.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9574791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10350881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teledermatology in Rural, Underserved, and Isolated Environments: A Review.","authors":"Sonya Ahuja,&nbsp;Shanelle Mariah Briggs,&nbsp;Sigrid Marie Collier","doi":"10.1007/s13671-022-00377-2","DOIUrl":"https://doi.org/10.1007/s13671-022-00377-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Summarize the current evidence for teledermatology in rural, underserved, and isolated environments including its use during the current COVID-19 pandemic.</p><p><strong>Recent findings: </strong>Teledermatology is a reliable and cost-effective tool that can reduce face-to-face visits and improve the timeliness of care for medically underserved populations. Recent studies have shown many additional benefits of teledermatology, including improving patients' health outcomes and increasing local providers' knowledge of dermatologic conditions. Despite these benefits, many low-income and rural populations lack access to digital technology and high-speed internet, limiting the reach of telemedical services.</p><p><strong>Summary: </strong>Overall, barriers in access to care are unique across the globe, and thus teledermatology interventions should address and adapt to the needs of the local patient population. Certain strategies, such as implementing simple, SF models, using standardized TD consult templets, and providing real-time information technology support could potentially mitigate disparities and improve the effectiveness of TD programs in underserved areas.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9589860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10349625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Immune-Modifying Treatments for Skin Diseases on the Immune Response to COVID-19 Vaccines: a Narrative Review.","authors":"Su-Yi Liew, Timothy Tree, Catherine H Smith, Satveer K Mahil","doi":"10.1007/s13671-022-00376-3","DOIUrl":"10.1007/s13671-022-00376-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>SARS-CoV-2 has had a devastating global effect, with vaccinations being paramount in the public health strategy against COVID-19. Vaccinations have uncoupled infection from adverse COVID-19 outcomes worldwide. While immune-modifying therapies are effective for the management of skin diseases such as psoriasis and atopic dermatitis, these medications also impair protective immune responses. There has been longstanding uncertainty and concern over the impact of immune-modifying therapies on the effectiveness of vaccines; for example, it is well recognised that methotrexate impairs humoral responses to both influenza and pneumococcal vaccines. This narrative review aims to discuss the evidence to date on the impact of immune-modifying therapies on the immune response to COVID-19 vaccines, with a focus on the first two vaccine doses.</p><p><strong>Recent findings: </strong>Individuals receiving immune-modifying therapy are more likely to have attenuated humoral responses to a single dose of COVID-19 vaccine compared to healthy controls; however, this may be improved by a complete course of vaccination. B cell targeted biologics such as rituximab markedly impair the humoral response to both the first and second COVID-19 vaccination. There remains a paucity of data on cellular immune responses, with the few available studies indicating lower responses to two vaccine doses in individuals receiving immune-modifying therapies compared to healthy controls, which may impact the durability of immune responses.</p><p><strong>Summary: </strong>Inadequate humoral immune responses to a single dose of vaccine in the context of immune-modifying therapy are improved by a complete course of vaccination. Individuals receiving immune-modifying treatments should be encouraged to take up a complete vaccine course to mitigate their risk against COVID-19. Research in large patient populations on the longevity/kinetics of the complex humoral and cellular response to subsequent vaccine doses, including against newer variants of concern, is warranted, in addition to data on immune correlates of vaccine clinical effectiveness.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9592867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10349623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophilic Dermatoses: a Clinical Update.","authors":"Emma H Weiss,&nbsp;Christine J Ko,&nbsp;Thomas H Leung,&nbsp;Robert G Micheletti,&nbsp;Arash Mostaghimi,&nbsp;Sarika M Ramachandran,&nbsp;Misha Rosenbach,&nbsp;Caroline A Nelson","doi":"10.1007/s13671-022-00355-8","DOIUrl":"https://doi.org/10.1007/s13671-022-00355-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Neutrophilic dermatoses are defined by the presence of a sterile neutrophilic infiltrate on histopathology. This review focuses on the pathogenesis, epidemiology, clinicopathological features, diagnosis, and management of four disorders: Sweet syndrome, pyoderma gangrenosum, Behçet syndrome, and neutrophilic eccrine hidradenitis.</p><p><strong>Recent findings: </strong>Recent studies have provided insight into the complex pathogenesis of neutrophilic dermatoses. Evidence supports an intricate interplay of abnormal neutrophil function and inflammasome activation, malignant transformation into dermal infiltrating neutrophils, and genetic predisposition.</p><p><strong>Summary: </strong>Neutrophilic dermatoses have diverse cutaneous and extracutaneous manifestations and may be associated with significant morbidity and mortality. Common underlying associations include infectious, inflammatory, and neoplastic disorders, as well as drug reactions. Emerging diagnostic and therapeutic frameworks identify an expanding role for biologic and targeted anti-inflammatory therapies.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40306359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophilic Dermatosis and Management Strategies for the Inpatient Dermatologist.","authors":"Nishi Shah, Maria S Asdourian, Ted V Jacoby, Steven T Chen","doi":"10.1007/s13671-022-00364-7","DOIUrl":"10.1007/s13671-022-00364-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Neutrophilic dermatoses are a heterogeneous group of disorders with significant overlap in associated conditions, clinical presentation, and histopathologic features. This review provides a structural overview of neutrophilic dermatoses that may present in the inpatient setting along with diagnostic work-up and management strategies.</p><p><strong>Recent findings: </strong>Sweet's syndrome has been found in patients with coronavirus disease 2019 (COVID-19). Pyoderma gangrenosum (PG) has been shown to be equally associated with ulcerative colitis and Crohn's disease. A clinical trial shows that cyclosporine is equally effective as prednisone in treating PG. Neutrophilic eccrine hidradenitis has been found in the setting of newer antineoplastic medications, such as BRAF inhibitors, as well as in the setting of malignancy without chemotherapy exposure.</p><p><strong>Summary: </strong>Neutrophilic dermatoses are a rare and complex group of dermatoses with varying and overlapping clinical presentations. Physicians should be aware of the growing list of associated diseases in order to build a better differential diagnosis or to potentially investigate for co-existing disease.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40533134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact Urticaria Syndrome: a Comprehensive Review.","authors":"Ana M Giménez-Arnau, David Pesqué, Howard I Maibach","doi":"10.1007/s13671-022-00379-0","DOIUrl":"10.1007/s13671-022-00379-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Contact urticaria syndrome includes contact urticaria and protein contact dermatitis. Underreport, underdiagnosis, or misdiagnosis of entities within the contact urticaria syndrome is believed to be common, especially in the occupational setting. This review provides a structured overview of the entities comprised in this syndrome as well as the diagnostic work-up and management strategies.</p><p><strong>Recent findings: </strong>Contact urticaria syndrome has been increasingly described due to personal protective equipment and hand sanitizers in the context of the COVID-19 pandemic. The use of legal cannabis products has led to a rise in occupational cases of contact urticaria to cannabis. A declining trend in the evolution of contact urticaria has been described for natural rubber latex allergy due to the use of synthetic gloves. Prick test has been proposed as a screening method, particularly if multiple products are to be tested, instead of the classical sequential scheme.</p><p><strong>Summary: </strong>Physicians should be aware of the growing number of culprit agents leading to contact urticaria syndrome. Clinical presentation may be challenging since it includes immediate urticaria and/or eczema and even more generalized reactions. Diagnosis requires a high degree of suspicion, detailed occupational history, and complementary tests, including skin testing. The best treatment is to avoid contact with the culprit agent and to implement preventive measures.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10344300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on the Delivery of Dermatological Care.","authors":"Alexa B Kimball,&nbsp;Martina L Porter","doi":"10.1007/s13671-022-00378-1","DOIUrl":"https://doi.org/10.1007/s13671-022-00378-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>We review several important changes affecting dermatology during the COVID-19 pandemic, beginning in March 2020. Specifically, we focus on the impact of the COVID-19 pandemic on physician trends in employment, delivery of care via teledermatology, and burnout, resilience, and wellness.</p><p><strong>Recent findings: </strong>More physicians are now employed by corporate entities than prior to the pandemic. Teledermatology can be utilized effectively and integrated into current care models; however, the continued use of teledermatology will largely depend on financial compensation. The COVID-19 pandemic was a source of burnout for all physicians, including dermatologists, and impacted how many people view their work.</p><p><strong>Summary: </strong>The COVID-19 pandemic pushed physicians to change their employment, required them to implement telehealth rapidly, and forced them to re-evaluate their priorities. Prior to the pandemic, more physicians transitioned into employed positions as compared to physician-owned practices. Multiple reasons for consolidation exist, but the trend accelerated during the COVID-19 pandemic for all medical specialties. Similarly, teledermatology was utilized prior to the pandemic, but its use exploded in the early days of the COVID-19 pandemic and continues to this day. The future of teledermatology though depends primarily on insurance reimbursement for these visits as well as both patient and physician preferences for continued usage. Lastly, wellness became a major focus in medicine as the pandemic took a significant toll on physicians, including dermatologists.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9734629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10392621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient Management of COVID-19: A Primer for the Dermatologist.","authors":"Sonia Wang, Joel M Gelfand, Cassandra Calabrese","doi":"10.1007/s13671-022-00368-3","DOIUrl":"10.1007/s13671-022-00368-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize diagnostic and therapeutic management of COVID-19 in the outpatient setting for dermatologists.</p><p><strong>Recent findings: </strong>Paxlovid (nirmatrelvir-ritonavir) is the preferred treatment in patients with mild symptoms at high risk of progression to severe SARS-CoV2 infection. Additional options include monoclonal antibodies (bebtelovimab), remdesivir, and molnupiravir.</p><p><strong>Summary: </strong>Dermatologists need to be aware of recent developments in diagnostic and therapeutic management of COVID-19 in the outpatient setting, as their patients may rely on dermatologists to provide advice, particularly in cases where treatments for dermatological disease may impact the risk of COVID-19 and/or vaccine efficacy.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13671-022-00368-3.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10409871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 Infection and Vaccination Cutaneous Manifestations for the Inpatient Dermatologist.","authors":"Sonia Himed,&nbsp;Ashley Gray,&nbsp;Zaynah Awethe,&nbsp;Karissa Libson,&nbsp;Benjamin H Kaffenberger,&nbsp;Abraham M Korman,&nbsp;John C L Trinidad","doi":"10.1007/s13671-022-00374-5","DOIUrl":"https://doi.org/10.1007/s13671-022-00374-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>The overall purpose of this review was to characterize and summarize cutaneous eruptions associated with coronavirus disease 2019 (COVID-19) as well as COVID-19 vaccination.</p><p><strong>Recent findings: </strong>Cutaneous eruptions associated with COVID-19 infection have a reported frequency of 1-20%. Increased COVID-19 disease severity has been associated with morbilliform exanthems, urticaria, retiform purpura, and livedo racemosa. Papulovesicular eruptions were associated with a milder COVID-19 disease course. A range of dermatoses have also been reported with COVID-19 vaccination but have rarely prevented subsequent vaccination.</p><p><strong>Summary: </strong>Dermatologists should be aware of the associations between COVID-19 disease severity and cutaneous eruptions. Livedo racemosa and retiform purpura are particularly associated with increased disease severity and death. In the setting of COVID-19 vaccination, cutaneous eruptions can largely be managed symptomatically and very rarely do these reactions prevent subsequent vaccination.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9579541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10274363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-Label Uses of Rituximab in Dermatology.","authors":"Connor Cole,&nbsp;Kyle T Amber","doi":"10.1007/s13671-022-00375-4","DOIUrl":"https://doi.org/10.1007/s13671-022-00375-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Rituximab has transformed the treatment of B-cell malignancies and rheumatoid arthritis in the past 2 decades. More recently, this anti-CD20 monoclonal antibody has seen increasing usage in the field of dermatology. This review highlights the evidence supporting its use in several important dermatologic conditions.</p><p><strong>Recent findings: </strong>Key recent findings include the 2018 FDA approval of rituximab for the treatment of moderate-to-severe pemphigus.</p><p><strong>Summary: </strong>Data from randomized controlled trials have demonstrated the efficacy of rituximab in pemphigus, ANCA-associated vasculitis, and cryoglobulinemic vasculitis. More limited data suggests its use in recalcitrant cases of diseases such as pemphigoid, epidermolysis bullosa acquisita, and dermatomyositis. There is scarce evidence and mixed results for rituximab when studied in cutaneous polyarteritis nodosa and cutaneous lupus erythematosus.</p>","PeriodicalId":10838,"journal":{"name":"Current Dermatology Reports","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10350321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}