Journal of Dermatology最新文献

{"title":"Exploring itch in hidradenitis suppurativa with lessons from atopic dermatitis and psoriasis","authors":"Nicole Trupiano,&nbsp;Kelly Young,&nbsp;Harika Echuri,&nbsp;Jalal Maghfour,&nbsp;Lauren A. V. Orenstein,&nbsp;Iltefat Hamzavi","doi":"10.1111/1346-8138.17622","DOIUrl":"10.1111/1346-8138.17622","url":null,"abstract":"<p>Itch is a prominent symptom in many cutaneous disorders, including atopic dermatitis (AD), prurigo nodularis, and psoriasis. Itch is also a common but overlooked concern in patients with hidradenitis suppurativa (HS). Currently, the mechanisms underlying itch in HS remain unclear. To gain a better understanding, we reviewed the literature on pruritus in HS and other itch-predominant disorders, AD, and psoriasis. In HS, psoriasis, and AD, we found that itch often co-localized with pain and occurred more frequently at night. Furthermore, itch was found to negatively affect sleep and increase the risk for comorbid psychiatric disorders in HS, psoriasis, and AD. However, HS-, psoriasis-, and AD-related itch differ in temporality. Itch in AD is often described as chronic, while itch in HS and psoriasis is often described as episodic. HS-associated itch is likely multifactorial, and several mechanisms have been proposed including peripheral sensitization, central sensitization, and neuroinflammation. Prior studies in HS highlight enhanced IgE production and a dense infiltration of mast cells, along with a variety of cytokines and chemokines. Furthermore, alterations in the skin microbiome may contribute to itch in HS. To date, few therapies have been studied to treat itch in HS. Given the efficacy of several biologics and small molecules in treating itch in AD and psoriasis, similar agents may be explored in future HS studies. Alternative therapies to target neurological and psychiatric contributions to itch may include anticonvulsants, cannabinoids, and nonpharmacological treatments. In conclusion, pathomechanisms of itch in HS remain to be fully elucidated. However, we can draw on lessons from other pruritic disorders to begin addressing the symptom of it and identify important questions for future study.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"239-246"},"PeriodicalIF":2.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of statins, gliptins, and antipsychotics with bullous pemphigoid: A case–control study in the Cretan population","authors":"Eirini Kavvalou,&nbsp;Konstantinos Krasagakis,&nbsp;Gregory Chlouverakis,&nbsp;Paraskevi Xekouki,&nbsp;Vasiliki Daraki,&nbsp;Charikleia Kouvidou,&nbsp;Eleni Lagoudaki,&nbsp;Sabine-Elke Krüger-Krasagakis","doi":"10.1111/1346-8138.17603","DOIUrl":"10.1111/1346-8138.17603","url":null,"abstract":"<p>Bullous pemphigoid (BP) is an autoimmune blistering disorder predominantly affecting the elderly. Recently, many studies have shed light on the effect of specific drug intake and comorbidities on the development of BP. The purpose of this study was to investigate the association of specific drug class intake and comorbidities with the development of BP in the Cretan population. Significant associations with BP were found for statins (odds ratio [OR] = 4.06, 95% confidence interval [CI] 1.99–8.27, <i>P</i> &lt; 0.001), gliptins (OR = 4.27, 95% CI 2.33–7.83, <i>P</i> &lt; 0.001), and antipsychotics (OR = 3.33, 95% CI 1.36–8.11, <i>P</i> = 0.006). Higher proportions of use in the BP group vs. control group were found for atorvastatin (OR = 1.86, 95% CI 1.04–3.32, <i>P</i> = 0.035), linagliptin (OR = 6.63, 95% CI 2.17–20.23, <i>P</i> &lt; 0.001), vildagliptin (OR = 3.20, 95% CI 1.73–5.91, <i>P</i> &lt; 0.001), alogliptin (OR = 5.11, 95% CI 1.19–22.04, <i>P</i> = 0.016), and quetiapine (OR = 4.21, 95% CI 1.5–11.85, <i>P</i> = 0.004). The presence of diabetes mellitus in the absence of gliptins did not show any significant effect on BP (OR = 1.60, 95% CI 0.79–3.23, <i>P</i> = 0.188). Metformin intake showed no significant association with BP (OR = 0.48, 95% CI 0.18–1.28, <i>P</i> = 0.143). Our findings confirm and extend previous studies reporting the association of gliptins and antipsychotics on BP in other European populations. The association found for statins is new, thus more studies are needed to corroborate its validity.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"291-298"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dangling digits","authors":"Lu Cao,&nbsp;Daiyue Wang,&nbsp;Ziqian Xu,&nbsp;Songting Wang","doi":"10.1111/1346-8138.17595","DOIUrl":"10.1111/1346-8138.17595","url":null,"abstract":"","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"e145-e146"},"PeriodicalIF":2.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical mucocutaneous manifestations of MPOX: A systematic review","authors":"Andrés Grau-Echevarría,&nbsp;Daniel Blaya-Imbernón,&nbsp;Malena Finello,&nbsp;Elena Pérez Zafrilla,&nbsp;Ángel González García,&nbsp;Rodrigo Peñuelas Leal,&nbsp;Carolina Labrandero-Hoyos,&nbsp;Jorge Magdaleno-Tapial,&nbsp;Esther Díez-Recio,&nbsp;Pablo Hernández-Bel","doi":"10.1111/1346-8138.17605","DOIUrl":"10.1111/1346-8138.17605","url":null,"abstract":"<p>MPOX is an orthopoxvirus whose infection has been declared a Public Health Emergency of International Concern in 2022 and 2024. It proved to be a virus with markedly heterogeneous and varied clinical presentation. We performed a systematic PubMed review of articles reporting cases of different clinical manifestations of MPOX until October 2024. The infection has mainly affected men who have sex with men. After 4 to 10 days of incubation, it presents with mucocutaneus lesions and systemic symptoms. Some anatomical sites have shown clinical particularities. Genital edema is a potentially serious complication. The ocular and ear/nose/throat area are other infrequent sites with specific manifestations. MPOX whitlow affects the third finger of the dominant hand and may be associated with extensive inflammation and proximal lymphangitis. Bacterial superinfection is a common complication in the genital area with good response to antibiotic treatment. Immunosuppressed patients may develop severe inflammation and necrosis resulting in poor prognosis. Some authors propose ulceronecrotic MPOX as a defining condition of AIDS. The involvement of women has been exceptional in the current outbreak and has predominantly affected the vulva. Some patients such as healthcare workers, atopics, and people who get tattoos are at risk of developing specific lesions via nonsexual routes. Other atypical manifestations include maculopapular rash and inguinal patch. MPOX is a highly relevant and ongoing infection that can present with multiple atypical manifestations, and the knowledge of which is of great importance to the clinician. We present a unique systematic review of atypical presentations of this infection that may be associated with significant morbidity and mortality, especially in the immunocompromised population.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"228-238"},"PeriodicalIF":2.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age over 90 years is an unfavorable prognostic factor for resectable cutaneous squamous cell carcinoma","authors":"Natsuko Saito-Sasaki,&nbsp;Megumi Aoki,&nbsp;Kazuyasu Fujii,&nbsp;Kentaro Yamamura,&nbsp;Taiyo Hitaka,&nbsp;Yui Hirano,&nbsp;Katsuhiko Nishihara,&nbsp;Yoshihisa Fujino,&nbsp;Shigeto Matsushita","doi":"10.1111/1346-8138.17551","DOIUrl":"10.1111/1346-8138.17551","url":null,"abstract":"<p>The rapid aging of the population has led to an increase in the number of cutaneous squamous cell carcinoma (cSCC) cases among the older population. However, the characteristics of these cases remain unclear. In this study, we aimed to identify the problem by analyzing the clinical characteristics of patients with cSCC aged 90 years and over. In this retrospective study, we analyzed the characteristics of patients aged &gt;90 years with regard to gender, risk factors for cSCC, and disease course, using data from 316 patients with cSCC who underwent surgery at the Kagoshima Medical Centre between October 2014 and September 2022. Patients were separated into two groups based on age: those aged ≥90 years (104 patients) and those aged &lt;90 years (212 patients). Regarding the National Comprehensive Cancer Network risk classification, there was no difference between groups. Univariate, multivariate, and Cox analyses of relapse-free survival of patients in both groups indicated that the recurrence risk was significantly high among those aged ≥90 years. Patients aged ≥90 years were at higher risk for recurrence, suggesting a need for closer follow-up than that for patients aged &lt;90 years.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 1","pages":"183-186"},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound, Pressure Ulcer, and Burn Guidelines-5: Guidelines for the management of lower leg ulcers and varicose veins, second edition","authors":"Takaaki Ito,&nbsp;Ryuichi Kukino,&nbsp;Yasuko Sarayama,&nbsp;Miki Tanioka,&nbsp;Takeo Maekawa,&nbsp;Hiroshi Yatsushiro,&nbsp;Jun Asai,&nbsp;Yoshihide Asano,&nbsp;Masatoshi Abe,&nbsp;Masahiro Amano,&nbsp;Ryuta Ikegami,&nbsp;Takayuki Ishii,&nbsp;Taiki Isei,&nbsp;Zenzo Isogai,&nbsp;Yuji Inoue,&nbsp;Ryokichi Irisawa,&nbsp;Yohei Iwata,&nbsp;Masaki Otsuka,&nbsp;Yoichi Omoto,&nbsp;Hiroshi Kato,&nbsp;Hideaki Tanizaki,&nbsp;Takafumi Kadono,&nbsp;Sakae Kaneko,&nbsp;Hiroyuki Kanoh,&nbsp;Tamihiro Kawakami,&nbsp;Masakazu Kawaguchi,&nbsp;Takeshi Kono,&nbsp;Monji Koga,&nbsp;Masanari Kodera,&nbsp;Keisuke Sakai,&nbsp;Eiichi Sakurai,&nbsp;Yoichi Shintani,&nbsp;Jun Tsujita,&nbsp;Naotaka Doi,&nbsp;Takeshi Nakanishi,&nbsp;Akira Hashimoto,&nbsp;Minoru Hasegawa,&nbsp;Masahiro Hayashi,&nbsp;Kuninori Hirosaki,&nbsp;Hideki Fujita,&nbsp;Manabu Fujimoto,&nbsp;Hiroshi Fujiwara,&nbsp;Koma Matsuo,&nbsp;Naoki Madokoro,&nbsp;Sei-Ichiro Motegi,&nbsp;Osamu Yamasaki,&nbsp;Yuichiro Yoshino,&nbsp;Andres Le Pavoux,&nbsp;Takao Tachibana,&nbsp;Hironobu Ihn","doi":"10.1111/1346-8138.17503","DOIUrl":"10.1111/1346-8138.17503","url":null,"abstract":"<p>“Wound, Pressure Ulcer, and Burn Guidelines-5: Guidelines for the management of lower leg ulcers and varicose veins, second edition” is revised from the first edition, which was published in the <i>Japanese Journal of Dermatology</i> in 2011. The guidelines were drafted by the Wound, Pressure Ulcer, and Burn Guidelines Drafting Committee delegated by the Japanese Dermatological Association and intend to facilitate physicians' clinical decisions in preventing, diagnosing and management of lower leg ulcers and varicose veins. We updated all sections by collecting documents published since the publication of the first edition. In particular, we added clinical question 8 (CQ8), which addresses endovenous laser ablation for varicose veins, a procedure that became covered by the Japanese national health insurance after the writing of the first edition, and endovenous radiofrequency ablation, which became covered by national health insurance in 2014. We also rearranged the subsequent clinical question (CQs) for easier reading. While the addition of these new techniques has increased the number of options available within the treatment algorithm, differences have arisen in the indication for surgery depending on the facility performing the treatment. Therefore, these have been abbreviated.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"e49-e69"},"PeriodicalIF":2.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"English version of clinical practice guidelines for the management of atopic dermatitis 2024","authors":"Hidehisa Saeki,&nbsp;Yukihiro Ohya,&nbsp;Hirokazu Arakawa,&nbsp;Susumu Ichiyama,&nbsp;Toshio Katsunuma,&nbsp;Norito Katoh,&nbsp;Akio Tanaka,&nbsp;Hideaki Tanizaki,&nbsp;Yuichiro Tsunemi,&nbsp;Takeshi Nakahara,&nbsp;Mizuho Nagao,&nbsp;Masami Narita,&nbsp;Michihiro Hide,&nbsp;Takao Fujisawa,&nbsp;Masaki Futamura,&nbsp;Koji Masuda,&nbsp;Tomoyo Matsubara,&nbsp;Hiroyuki Murota,&nbsp;Kiwako Yamamoto-Hanada,&nbsp;Junichi Furuta","doi":"10.1111/1346-8138.17544","DOIUrl":"10.1111/1346-8138.17544","url":null,"abstract":"<p>This is the English version of the 2024 clinical practice guidelines for the management of atopic dermatitis (AD). AD is a disease characterized by relapsing eczema with pruritus as a primary lesion. A crucial aspect of AD treatment is the prompt induction of remission via the suppression of existing skin inflammation and pruritus. To achieve this, topical anti-inflammatory drugs, such as topical corticosteroids, tacrolimus ointment, delgocitinib ointment, and difamilast ointment, have been used. However, the following treatments should be considered in addition to topical therapy for patients with refractory moderate-to-severe AD: oral cyclosporine, subcutaneous injections of biologics (dupilumab, nemolizumab, tralokinumab), oral Janus kinase inhibitors (baricitinib, upadacitinib, abrocitinib), and phototherapy. In these revised guidelines, descriptions of five new drugs, namely, difamilast, nemolizumab, tralokinumab, upadacitinib, and abrocitinib, have been added. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"e70-e142"},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase 2, randomized, double-blind, vehicle-controlled trial of tapinarof cream in Japanese pediatric patients with atopic dermatitis","authors":"Atsuyuki Igarashi,&nbsp;Gaku Tsuji,&nbsp;Ryusei Murata,&nbsp;Shuichi Fukasawa,&nbsp;Satoshi Yamane","doi":"10.1111/1346-8138.17587","DOIUrl":"10.1111/1346-8138.17587","url":null,"abstract":"<p>Tapinarof is a nonsteroidal, topical, aryl hydrocarbon receptor agonist approved for the treatment of atopic dermatitis (AD) in Japanese patients aged ≥12 years. We evaluated the efficacy and safety of tapinarof in Japanese pediatric patients aged 2 to 11 years with AD in a phase 2, multicenter, randomized, double-blind, vehicle-controlled trial. Eligible patients (<i>N</i> = 121) were randomized 1:1:1 to receive tapinarof cream 0.5%, tapinarof cream 1%, or vehicle cream once daily for 8 weeks. At week 8, the least-squares mean percent change from baseline in Eczema Area and Severity Index (EASI) score (the primary endpoint) was −81.29% in the tapinarof 0.5% group, −77.62% in the tapinarof 1% group, and − 18.56% in the vehicle group. Reductions in EASI score at week 8 were significantly greater in the tapinarof groups than in the vehicle group (<i>p</i> &lt; 0.0001 for both comparisons). The proportion of patients with ≥75% improvement from baseline in EASI score at week 8 was 77.5% in the tapinarof 0.5% group, 70.7% in the tapinarof 1% group, and 15.0% in the vehicle group. The proportion of patients who achieved an Investigator's Global Assessment score of 0 (clear) or 1 (almost clear) with ≥2-grade improvement from baseline at week 8 was 32.5% in the tapinarof 0.5% group, 43.9% in the tapinarof 1% group, and 17.5% in the vehicle group. No treatment-related serious adverse events (AEs) were reported; all of the AEs were mild or moderate. Common AEs in tapinarof-treated patients included gastroenteritis, application site irritation, and nasopharyngitis. The incidence of trial discontinuations due to AEs was low in tapinarof-treated patients (one patient for each strength). In summary, both strengths of tapinarof cream demonstrated greater efficacy than vehicle cream and were well tolerated in Japanese pediatric patients with AD.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"247-255"},"PeriodicalIF":2.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of guselkumab for avelumab-induced psoriasis in urothelial carcinoma: A case report","authors":"Kazuki Yatsuzuka,&nbsp;Satoshi Yoshida,&nbsp;Noriyoshi Miura,&nbsp;Nobushige Kohri,&nbsp;Jun Muto,&nbsp;Ken Shiraishi,&nbsp;Yasuhiro Fujisawa","doi":"10.1111/1346-8138.17583","DOIUrl":"10.1111/1346-8138.17583","url":null,"abstract":"&lt;p&gt;Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, their use is often accompanied by immune-related adverse events, including skin manifestations. Although topical corticosteroids are typically effective, systemic therapies are sometimes required. In severe cases, ICIs may need to be withheld.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; ICI-mediated psoriasis (ICMP), characterized by new-onset or worsening psoriasis, is a recognized adverse effect of ICI.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Recent studies have demonstrated the successful management of ICMP using biologics without ICI discontinuation.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; We present a case of ICMP effectively treated with biologics while continuing ICI therapy.&lt;/p&gt;&lt;p&gt;A 59-year-old man presented with widespread erythematous plaques. Despite achieving near-complete remission of psoriasis vulgaris with topical steroids for the past 6 months, he developed erythematous plaques with infiltration and scaling on his face, extremities, and trunk within a month of initiating avelumab for advanced urothelial carcinoma (Figure 1a,b). A skin biopsy revealed hyperkeratosis, parakeratosis, elongation of the rete ridges, and neutrophil infiltration into the epidermis (Figure 1c,d). We diagnosed a flare-up of psoriasis vulgaris induced by avelumab and temporarily suspended avelumab despite its oncological efficacy. Psoriasis area and severity index (PASI) score at flare-up was 13.2. Since the eruptions were resistant to very strong topical steroids, we added narrowband UV-B therapy and the PASI score improved to 2.1 after 3 weeks. Although avelumab was reintroduced, the PASI score worsened to 8.4 within a month. After the addition of apremilast, the PASI score decreased to 1.4. However, 10 months after apremilast initiation, a third flare-up occurred, with the PASI score escalating to 9.6 (Figure 1e,f). Considering the sustained partial response of urothelial carcinoma to avelumab, we decided to switch psoriasis treatment to guselkumab while continuing avelumab. Consequently, a 50% PASI improvement was observed at 12 weeks (Figure 1g,h), with further improvement to a PASI score of 1.2 at 28 weeks without AEs. His urothelial cancer remains under control with continued avelumab.&lt;/p&gt;&lt;p&gt;Topical agents are the mainstay of treatment for ICMP. Switching to a different class of ICI should also be considered. Nikolaou et al.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; proposed algorithm-based management strategies. Although their algorithm prioritizes ICI continuation, a significant proportion of their cohort (18%) required permanent ICI discontinuation because of psoriasis.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Recent studies have emphasized the efficacy and safety of biologics, particularly interleukin (IL) 23 and IL-17 inhibitors, in the management of psoriasis concurrently with cancer treatment.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Studies have shown that reduced tumor expression of psoriasis pathway mediators such as IL-17A and IL-23A do not affect ove","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"e147-e148"},"PeriodicalIF":2.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17583","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evaluation of Congo red staining combined with fluorescence microscopy in the diagnosis of primary cutaneous amyloidosis","authors":"Hanqing Song,&nbsp;Yin Cheng,&nbsp;Xiuqin Wang,&nbsp;Xinyi Hong,&nbsp;Ze Guo,&nbsp;Hui Li,&nbsp;Li Li,&nbsp;Peiguang Wang","doi":"10.1111/1346-8138.17562","DOIUrl":"10.1111/1346-8138.17562","url":null,"abstract":"<p>Primary cutaneous amyloidosis (PCA) is a chronic pruritic skin disease. The apple-green birefringence of Congo red-stained amyloid under a polarized light microscope (CR-PLM) remains the gold standard in the diagnosis of PCA. However, there are some limitations to this approach. In this study, eighty-two paraffin-embedded biopsy skin samples were collected from patients with a clinical diagnosis of PCA. The sections were respectively stained with hematoxylin–eosin (HE), crystal violet (CV), and Congo red (CR) and observed under a light microscope. CR-stained sections were also observed under a polarized light microscope (CR-PLM) or an ultraviolet (UV)-emitted fluorescence microscope (CR-UFM). Further, 35 cases clinically diagnosed with psoriasis, lichen planus, and prurigo nodularis were selected as the negative control group. The positive rate of amyloid protein detected by CR-UFM (81.71%) was significantly higher than that detected by CR-PLM (70.73%, <i>p</i> = 0.004), CR staining (56.10%, <i>p</i> &lt; 0.001), CV staining (30.49%, <i>p</i> &lt; 0.001), or HE staining (28.05%, <i>p</i> &lt; 0.001). In the control group, 34 (97.14%) cases were negative for amyloid deposits in CR staining, CR-PLM, and CR-UFM sections. The relative number of positive dermal papillae observed by CR-UFM (0.35 ± 0.27) was much more than that observed by CR-PLM (0.15 ± 0.17, <i>p</i>&lt;0.001), CR staining (0.12 ± 0.16, <i>p</i> &lt; 0.001), CV staining (0.07 ± 0.12, <i>p</i> &lt; 0.001), or HE staining (0.05 ± 0.12, <i>p</i> &lt; 0.001). The intensity of fluorescence by CR-UFM was significantly greater than that of the appl-green birefringence by CR-PLM (<i>p</i> &lt; 0.001). Moreover, the amyloid was easily distinguished from the surrounding tissues using the CR-UFM method. In conclusion, the CR-UFM method was superior to CR-PLM, CR staining, CV staining, and HE staining in diagnosing PCA.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"52 2","pages":"281-290"},"PeriodicalIF":2.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.17562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}