Dermatology (Basel, Switzerland)最新文献

{"title":"Long-Term Effectiveness and Drug Survival of Apremilast in Treating Psoriasis: A Real-World Experience.","authors":"Julian Distel,&nbsp;Simone Cazzaniga,&nbsp;S Morteza Seyed Jafari,&nbsp;Vladimir Emelianov,&nbsp;Christoph Schlapbach,&nbsp;Nikhil Yawalkar,&nbsp;Kristine Heidemeyer","doi":"10.1159/000515763","DOIUrl":"https://doi.org/10.1159/000515763","url":null,"abstract":"<p><strong>Background: </strong>Apremilast is an oral phosphodiesterase 4 (PDE4) inhibitor used for the treatment of moderate to severe psoriasis. Long-term data on the effectiveness and drug survival of patients treated with apremilast are limited.</p><p><strong>Objective: </strong>The aim of this study was to analyze the characteristics, effectiveness, and drug survival of patients treated with apremilast in a real-world setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients with psoriasis who received at least 1 dose of apremilast between 2015 and 2018. We documented sex; age; type, duration, and severity (using Psoriasis Area Severity Index [PASI] and Dermatology Life Quality Index [DLQI]) of psoriasis; comorbidities; previous treatment modalities; adverse events; and reasons for therapy discontinuation. For drug survival, estimates and efficacy analysis with Kaplan-Meier statistics were used.</p><p><strong>Results: </strong>The drug survival rate of the 93 reviewed patients was 69.5% at 6 months, 34.7% at 12 months, and 25.8% at 24 months after initiating therapy. The median survival duration was 8.0 months. Therapy was discontinued in 66.6 and 27.8% due to loss of efficacy and adverse events, respectively. At 24 months, 35.9% had achieved PASI75 response and 23.7% had achieved PASI90 response. Most observed adverse events were gastrointestinal issues, weight loss, and headache.</p><p><strong>Conclusions: </strong>Apremilast is an effective and well-tolerated therapy for patients with moderate to severe psoriasis, especially for patients with difficult-to-treat locations and/or contraindications to other biologics. Furthermore, apremilast was used for patients with a history of nonresponse to biologics and was favored for patients with relatively low PASI (<10) and a high DLQI.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"267-275"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000515763","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38996816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy as a Treatment Option for Local Disease Control in Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type.","authors":"Mara Zehnder,&nbsp;Boyko Amarov,&nbsp;André N Abrunhosa-Branquinho,&nbsp;Mirjana Maiwald-Urosevic,&nbsp;Beda Mühleisen,&nbsp;Ieva Saulite,&nbsp;Florian Anzengruber,&nbsp;Laurence Imhof,&nbsp;Alexander A Navarini,&nbsp;Antonio Cozzio,&nbsp;Reinhard Dummer,&nbsp;Florentia Dimitriou,&nbsp;Emmanuella Guenova","doi":"10.1159/000522053","DOIUrl":"https://doi.org/10.1159/000522053","url":null,"abstract":"<p><strong>Background: </strong>Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is an aggressive lymphoma variant. Anthracycline-based chemotherapy with rituximab is recommended as first-line treatment. Radiotherapy (RT) has been considered as a therapeutic option for local disease control in patients with solitary or localized lesions.</p><p><strong>Methods: </strong>We report the results of a retrospective analysis of PCDLBC, LT patients treated either with RT alone or with physician's decision as first-line treatment, aiming to assess disease progression and/or first recurrence in these treatment groups.</p><p><strong>Results: </strong>We retrospectively analyzed 20 patients treated either with RT alone (n = 8) or with investigator's choice treatment (n = 12), which included chemotherapy alone or combined with local therapy (RT and wide local excision). Complete response (CR) was achieved in 8 patients from the first group and 9 patients from the second group, with 1 treatment failure. Six patients treated with RT alone progressed with a median time to progression (TTP) of 12.5 months. In the second group, 5 patients progressed with a median TTP of 5.2 months. RT showed good local disease control in both groups without any skin relapses during the follow-up period.</p><p><strong>Conclusion: </strong>RT as first-line monotherapy followed by watchful waiting did not significantly improve the overall risk of disease progression but resulted in good local disease control. After progression, RT could still easily be combined with systemic treatment. The strength of this analysis needs to be evaluated in a larger patient cohort.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"967-976"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39614691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Personal Impact of Daily Wound Care for Hidradenitis Suppurativa.","authors":"Suzanne Moloney,&nbsp;Barry M McGrath,&nbsp;Davood Roshan,&nbsp;Georgina Gethin","doi":"10.1159/000520262","DOIUrl":"https://doi.org/10.1159/000520262","url":null,"abstract":"Background: Recurring nodules, abscesses, and lesions characterise hidradenitis suppurativa (HS): a chronic, inflammatory skin disorder. Globally the prevalence of HS is estimated to be around 1% of the population. Leakage, pain, and odour from HS wounds require substantial management. Little is known of the personal burdens that routine wound management imposes on the patient. Objectives: To evaluate how routine HS wound management impacts patients in terms of the time spent changing dressings, the number of dressings required per day, pain experienced during dressing changes, and negative impact on various domains of their personal lives. Methods: An anonymous online questionnaire was posted on closed social media patient support groups between April and May 2019. Pearson χ2 test was used to evaluate if Hurley stages influenced the personal impact of wound care routines on patients. Statistical significance was determined as p value <0.05. Results: In total, 908 people from 28 countries responded. Of these, 81% (n = 734) reported that regular dressing changes negatively impacted on their quality of life. Most patients, 82% (n = 744), experience pain during dressing changes. 16% (n = 142) of patients required five or more dressings daily, and 12% (n = 108) spend over 30 min daily tending to wounds. Patients indicated high levels of dissatisfaction with currently available wound dressings. Conclusion: HS wound management imposes a substantial personal burden on patients. There is a clear unmet need for HS-specific wound dressings and wound care provisions, and a greater awareness of the condition and its impact is needed among clinicians.","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"762-771"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39742294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn Hemangioma: A New Variant of Hemangioma.","authors":"Khalifa E Sharquie,&nbsp;Muhsin A Al-Dhalimi,&nbsp;Ahmed Abdulhussein Kawen,&nbsp;Samer A Dhaher","doi":"10.1159/000520616","DOIUrl":"https://doi.org/10.1159/000520616","url":null,"abstract":"<p><strong>Background: </strong>Burn hemangioma, also known as scalded pyogenic granuloma, is considered a variant of pyogenic granuloma, but unlike the classic type it presents with rapid progression. Most patients are infants and young children with a history of burns caused by liquids.</p><p><strong>Objective: </strong>The present study aims to present all patients with burn hemangiomas treated at our institutions with a full clinical and histopathological assessment.</p><p><strong>Patients and methods: </strong>This case series includes 34 cases that were treated during the period from 2016 to 2021.</p><p><strong>Results: </strong>A total of 34 patients (16 female/18 male, mean age of 17.6 years) were included. Two age groups presented: infants and children (n = 22, age range 0.5-8 years, 10 female/12 male), and adults (n = 11, age range 25-44 years, 6 female/6 male). Lesions appeared 1-2 weeks following predominantly second-degree burns, and multiple lesions predominated in infants and children. The lesions evolved to large lesions within weeks, and these appeared to be either static or involute. The histopathology was compatible with hemangioma, rather than pyogenic granuloma.</p><p><strong>Conclusion: </strong>Burn hemangioma should be considered a new variant of hemangioma rather than a type of pyogenic granuloma that follows second-degree burns. They have many similarities with infantile hemangioma, both clinically and histopathologically.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"793-798"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39768066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Impact and Management of Persistent Head and Neck Atopic Dermatitis in Dupilumab-Treated Patients.","authors":"Andrea Chiricozzi,&nbsp;Niccolò Gori,&nbsp;Lucia Di Nardo,&nbsp;Flaminia Antonelli,&nbsp;Cristiano Caruso,&nbsp;Giacomo Caldarola,&nbsp;Laura Calabrese,&nbsp;Cristina Guerriero,&nbsp;Clara De Simone,&nbsp;Ketty Peris","doi":"10.1159/000519361","DOIUrl":"https://doi.org/10.1159/000519361","url":null,"abstract":"<p><strong>Background: </strong>Localization of atopic dermatitis (AD) in exposed areas such as the hands, head, and neck has been considered as a negative factor impacting on dupilumab response, although a comparison of exposed versus unexposed areas is not currently available.</p><p><strong>Objectives: </strong>The aim of this study is to evaluate the clinical response to dupilumab depending on the presence or persistency of AD skin manifestations in specific body areas.</p><p><strong>Methods: </strong>The study retrospectively collected clinical and demographic data of adult patients affected by moderate to severe AD. Based on the anatomical sites involved, 5 subcohorts of patients were identified.</p><p><strong>Results: </strong>A total of 41 patients were included in the study. Disease amelioration was detected during the study period, although baseline head/neck and hand localization was associated with a significantly lower likelihood of achieving an Eczema Area Severity Index (EASI) ≤1. In addition, patients with head/neck persistency showed a significantly lower response when compared to patients without persistency of head/neck AD in terms of both mean EASI and Dermatology Life Quality Index (DLQI) reduction.</p><p><strong>Conclusion: </strong>AD localization in exposed areas at the baseline and AD persistency at the head/neck may have a negative impact on certain treatment response parameters to dupilumab therapy.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"717-724"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39823879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Market-Approved Artificial Intelligence Mobile Health App for Skin Cancer Screening: A Prospective Multicenter Diagnostic Accuracy Study.","authors":"Tobias Sangers,&nbsp;Suzan Reeder,&nbsp;Sophie van der Vet,&nbsp;Sharan Jhingoer,&nbsp;Antien Mooyaart,&nbsp;Daniel M Siegel,&nbsp;Tamar Nijsten,&nbsp;Marlies Wakkee","doi":"10.1159/000520474","DOIUrl":"https://doi.org/10.1159/000520474","url":null,"abstract":"<p><strong>Background: </strong>Mobile health (mHealth) consumer applications (apps) have been integrated with deep learning for skin cancer risk assessments. However, prospective validation of these apps is lacking.</p><p><strong>Objectives: </strong>To identify the diagnostic accuracy of an app integrated with a convolutional neural network for the detection of premalignant and malignant skin lesions.</p><p><strong>Methods: </strong>We performed a prospective multicenter diagnostic accuracy study of a CE-marked mHealth app from January 1 until August 31, 2020, among adult patients with at least one suspicious skin lesion. Skin lesions were assessed by the app on an iOS or Android device after clinical diagnosis and before obtaining histopathology. The app outcome was compared to the histopathological diagnosis, or if not available, the clinical diagnosis by a dermatologist. The primary outcome was the sensitivity and specificity of the app to detect premalignant and malignant skin lesions. Subgroup analyses were conducted for different smartphone types, the lesion's origin, indication for dermatological consultation, and lesion location.</p><p><strong>Results: </strong>In total, 785 lesions, including 418 suspicious and 367 benign control lesions, among 372 patients (50.8% women) with a median age of 71 years were included. The app performed at an overall 86.9% (95% CI 82.3-90.7) sensitivity and 70.4% (95% CI 66.2-74.3) specificity. The sensitivity was significantly higher on the iOS device compared to the Android device (91.0 vs. 83.0%; p = 0.02). Specificity calculated on benign control lesions was significantly higher than suspicious skin lesions (80.1 vs. 45.5%; p < 0.001). Sensitivity was higher in skin fold areas compared to smooth skin areas (92.9 vs. 84.2%; p = 0.01), while the specificity was higher for lesions in smooth skin areas (72.0 vs. 56.6%; p = 0.02).</p><p><strong>Conclusion: </strong>The diagnostic accuracy of the mHealth app is far from perfect, but is potentially promising to empower patients to self-assess skin lesions before consulting a health care professional. An additional prospective validation study, particularly for suspicious pigmented skin lesions, is warranted. Furthermore, studies investigating mHealth implementation in the lay population are needed to demonstrate the impact on health care systems.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"649-656"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39892442","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":"Dermoscopic Nevus Patterns Associated with Melanoma Patients.","authors":"Clarissa Prieto Herman Reinehr,&nbsp;Renato Marchiori Bakos","doi":"10.1159/000520164","DOIUrl":"https://doi.org/10.1159/000520164","url":null,"abstract":"<p><strong>Background: </strong>The quantitative and qualitative presence of melanocytic nevi is considered a significant risk factor for melanoma. Little is known whether patients showing any of the recognized global dermoscopic nevus patterns might also be considered at increased risk for the disease.</p><p><strong>Objectives: </strong>We aimed to investigate the frequency of global dermoscopic patterns of common nevi among melanoma patients and compare them to controls, as well as the dermoscopic patterns of atypical nevi between the groups.</p><p><strong>Methods: </strong>We included consecutive melanoma patients and age- and sex-matched controls who presented to our Department with at least 10 melanocytic nevi. Total body examination was performed, and all nevi had their dermoscopic pattern described. Global dermoscopic patterns of nevi were compared between groups, as well as atypical nevus patterns. Finally, nevus patterns were stratified by their location and also compared between groups.</p><p><strong>Results: </strong>We included 120 melanoma patients and 120 controls. Melanoma patients presented a larger number of common (p = 0.002) and atypical melanocytic nevi (p < 0.001) and more variability of dermoscopic nevus patterns (p < 0.001). No difference in the global dermatoscopic pattern of common nevi was observed between groups. The complex pattern of atypical nevi was associated with melanoma (OR = 2.87). Melanoma patients also showed more common nevi with a reticular pattern on the back (p = 0.014) and lower limbs (p = 0.041) as well as atypical nevi on the back with reticular pattern (p = 0.01), with reticular-homogeneous pattern (p = 0.001), and with reticular-globular pattern (p = 0.048) than controls. Nevi with multifocal pigmentation were also more frequent among melanoma patients (OR = 2.61).</p><p><strong>Conclusion: </strong>Melanoma patients tend to present a higher number of common reticular nevi on the back and lower limbs, as well as atypical nevi with a complex pattern, especially reticular, reticular-homogeneous, and reticular-globular on the back.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"670-676"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39599588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Cochrane Library: Statins and Fibrates for Preventing Melanoma.","authors":"Abigail L Meckley,&nbsp;Michelle Militello,&nbsp;Torunn E Sivesind,&nbsp;Lisa Schilling,&nbsp;Robert P Dellavalle","doi":"10.1159/000520709","DOIUrl":"https://doi.org/10.1159/000520709","url":null,"abstract":"","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"668-669"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39698728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Localized Cutaneous Amyloidosis: A Retrospective Study of an Uncommon Skin Disease in the Largest Tertiary Care Center in Switzerland.","authors":"Carole Guillet,&nbsp;Simona Steinmann,&nbsp;Julia-Tatjana Maul,&nbsp;Isabel Kolm","doi":"10.1159/000518948","DOIUrl":"https://doi.org/10.1159/000518948","url":null,"abstract":"<p><strong>Background: </strong>Primary localized cutaneous amyloidosis (PLCA) is defined by the deposition of amyloid protein in the skin without systemic involvement. There are four subtypes of PLCA: lichen amyloidosis (LA), macular amyloidosis (MA), biphasic amyloidosis (BA), and nodular amyloidosis (NA). PLCA occurs most frequently in Latin Americans and Asians. Treatment is not standardized.</p><p><strong>Objectives: </strong>To identify subtypes, demographic and clinical features and treatment efficacy in patients with histopathologically confirmed PLCA.</p><p><strong>Materials and methods: </strong>Data of PLCA patients were extracted from the electronic hospital database and included if diagnosis of PLCA was histopathologically confirmed and if sufficient information regarding treatment and follow-up was available. The evaluation of the treatment efficacy was based on a novel score to assess the reduction of itch and skin lesions.</p><p><strong>Results: </strong>In this retrospective, monocentric study, 37 cases of PLCA diagnosed between 2000 and 2020 were included (21 females) with a mean age of 52 years. LA was the most frequent subtype found in 21 patients (56.8%), followed by MA in 10 patients (28%) and BA in 6 patients (16.2%). No cases of NA were included. 22 patients (59.4%) had skin phototype II or III. Regarding treatment, a combination of UVA1 phototherapy with high-potency topical corticosteroids seemed to show the highest efficacy with complete clearance of symptoms in 4 patients (10.8%). A substantial improvement of symptoms was found in 5 patients (12.7%) treated with high-potency topical corticosteroids alone or in combination either with UVA1 or bath PUVA or monotherapy with UVA1 phototherapy or capsaicin (0.075%) cream. Low-/medium-potency topical corticosteroids alone or in combination with UVBnb (311 nm) phototherapy showed a lower efficacy.</p><p><strong>Conclusion: </strong>Our data show that PCLA is a rare disease in central Europe but can also be expected in a predominantly Caucasian population. The best treatment response was achieved with a combination of UVA1 phototherapy and high-potency topical corticosteroids.</p>","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"579-586"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9153345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39418590","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":"Staphylococcus aureus and Antibiotics in Cutaneous T-Cell Lymphoma.","authors":"Lise M Lindahl,&nbsp;Lars Iversen,&nbsp;Niels Ødum,&nbsp;Mogens Kilian","doi":"10.1159/000517829","DOIUrl":"https://doi.org/10.1159/000517829","url":null,"abstract":"","PeriodicalId":144585,"journal":{"name":"Dermatology (Basel, Switzerland)","volume":" ","pages":"551-553"},"PeriodicalIF":3.4,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39497043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}