Skin (Milwood, N.Y.)最新文献

{"title":"The Importance of Medication Adherence in the Treatment of Actinic Keratosis: An Expert Consensus Panel","authors":"D. Zakria, A. Armstrong, B. Berman, J. D. Del Rosso, M. Lebwohl, T. Schlesinger, D. Rigel","doi":"10.25251/skin.7.3.1","DOIUrl":"https://doi.org/10.25251/skin.7.3.1","url":null,"abstract":"Background: Actinic keratosis (AK) is one of the most common dermatologic diagnoses. While there are several treatment options, many topical therapies have poor adherence due to duration of treatment and local skin reactions (LSRs). \u0000Objective: To review the available literature on the most commonly used patient-administered field-directed therapies for AK and create consensus statements on the role of medication adherence in improving AK outcomes. \u0000Methods: A literature search of PubMed was completed for English-language original research articles reporting efficacy, safety, and tolerability data for 5-FU, diclofenac gel, imiquimod cream, and tirbanibulin. Once the articles were selected, they were distributed to a panel consisting of seven dermatologists with extensive expertise in managing AKs. Each panelist reviewed the articles and assigned them a level of evidence based on Strength of Recommendation Taxonomy (SORT) criteria. The panelists then met to review and discuss the studies and created consensus statements on the management of AKs and the importance of medication compliance. A modified Delphi process was used to approve the adoption of each statement. \u0000Results: The literature search produced 1,326 articles that met search criteria. After screening these articles for relevance and applying the inclusion criteria, 17 articles were chosen to be reviewed by the panel and assigned a level of evidence based on SORT criteria. The panel then created six consensus statements that received a unanimous vote for adoption. \u0000Conclusion: While there are several options for the treatment of AK, there is little consensus on a standard of care. Clearance rates for the most common topical field therapies vary significantly but are also difficult to directly compare due to differences in methodology for measuring and assessing outcomes. Overall, it is clear that an efficacious, tolerable, and convenient treatment for AKs is critical to optimal adherence and management and, given the results of recent studies, tirbanibulin may be the best topical option for meeting these criteria.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47135119","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":"Leukemia Cutis as the Presenting Sign of Acute Myeloid Leukemia in an HIV+ patient","authors":"Natalie Garcia, Charlotte Mcrae, Abigail O. Smith, L. Graham","doi":"10.25251/skin.7.3.11","DOIUrl":"https://doi.org/10.25251/skin.7.3.11","url":null,"abstract":"Leukemia Cutis (LC) is a rare extramedullary cutaneous manifestation of leukemia that varies in terms of clinical presentation, leukemia type, and timing of presentation in relation to systemic leukemia. LC typically presents following diagnosis of systemic leukemia and during an active flare or relapse. An estimated 3.7% of patients with Acute Myeloid Leukemia (AML) develop LC. A 61-year-old male with poorly controlled HIV presented with a rash that began one month prior on his cheek as a red papule, which he believed was an ingrown hair. On exam, pink and yellow firm papules and nodules covered his entire body surface except the groin and axilla. One nodule held a peau d’orange appearance. The rash was overall asymptomatic, and he reported only increased fatigue. His CD4 count and viral load were 136 and 330,000 respectively. One punch biopsy revealed negative cultures for fungus, bacteria, and acid-fast bacilli. Two biopsies sent for pathologic evaluation revealed AML of the skin. Bone marrow biopsy confirmed AML. Clinically the presentation of LC is nonspecific, and systemic symptoms rarely appear in conjunction with LC. High clinical suspicion and histopathologic examination are necessary for diagnosis of LC.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42259324","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":"Bazex Syndrome Associated with Angioimmunoblastic T-cell Lymphoma","authors":"G. Ugoh, A. Linfante, Allison J. Good, Janice M. Wilson, Kathleen Kroger","doi":"10.25251/skin.7.3.14","DOIUrl":"https://doi.org/10.25251/skin.7.3.14","url":null,"abstract":"Bazex syndrome, also known as Acrokeratosis paraneoplastica, is a paraneoplastic disorder characterized by erythematous psoriasiform plaques involving the nose, ears, and acral sites. Although classically associated with squamous cell carcinomas of the upper aerodigestive tract, it has also been reported in association with adenocarcinoma, genitourinary tumors, multiple myeloma, and rarely, peripheral T-cell lymphoma and follicular lymphoma in-situ. Herein, we present a patient with Bazex syndrome associated with angioimmunoblastic T-cell lymphoma (AITL), a rare association not previously reported in the literature.  ","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46017461","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":"Real-world effectiveness of ixekizumab in mild, moderate, and severe psoriasis: The patient perspective","authors":"A. Gottlieb, R. Burge, W. Malatestinic, B. Zhu, Yunyang Zhao, J. McCormack, M. Kimel, M. Feely, J. Merola","doi":"10.25251/skin.7.supp.202","DOIUrl":"https://doi.org/10.25251/skin.7.supp.202","url":null,"abstract":"","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42599592","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":"Psoriatic Arthritis Flare in a Hospitalized Patient with Schizoaffective Disorder: A Case Report","authors":"P. Arora, Tracy Tomac","doi":"10.25251/skin.7.3.12","DOIUrl":"https://doi.org/10.25251/skin.7.3.12","url":null,"abstract":"Psoriasis is a known comorbid condition in patients with schizophrenia spectrum disorders. Due to the nature of these psychiatric conditions, many experience lengthy hospitalizations and self-isolate at baseline, which can make identification and management of psoriasis difficult. We report the case of a middle-aged male with a history of schizoaffective disorder and treatment-resistant psoriatic arthritis who experienced a severe flare while hospitalized. His two-month hospital stay became complicated by combative behavior and continued medication refusal, resulting in repeated seclusion events and eventual transfer to a higher acuity unit. After treatment with ixekizumab and a course of prednisone was initiated one month after admission and symptom onset, the patient’s lesions were tremendously improved along with his mood on the unit. With the improvement in his chronic pain and discomfort, the patient was able to focus on mental health recovery and rapidly approached discharge. This report highlights the importance of appropriate management of comorbid conditions, especially psoriasis in patients with schizophrenia spectrum disorders needing long-term hospitalization. Additionally, this case demonstrates the successful use of ixekizumab in treatment-resistant psoriasis.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42827139","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":"Comparison of patient and clinician satisfaction with tirbanibulin treatment’s ability to improve ‘how skin looks’ and ‘skin texture’ in the treated area, among patients with Actinic Keratosis treated with tirbanibulin in community practices across U.S.","authors":"M. Lebwohl, D. Rigel, T. Schlesinger, A. Armstrong, B. Berman, N. Bhatia, J. D. Del Rosso, L. Kircik, Vishal Patel, Siva Narayanan, V. Koscielny, I. Kasujee","doi":"10.25251/skin.7.supp.213","DOIUrl":"https://doi.org/10.25251/skin.7.supp.213","url":null,"abstract":"Introduction: The objective of this analysis was to compare patient and clinician satisfaction with tirbanibulin treatment’s ability to improve ‘how skin looks’ and ‘skin texture’ in the treated area, among patients with Actinic Keratosis (AK) treated with tirbanibulin in community practices across the U.S. Methods: A single-arm, prospective cohort study (PROAK) was conducted among adult patients with AKs on the face or scalp who were newly initiated with once-daily tirbanibulin treatment (5-day course) in real-world community practices in the U.S, as part of usual care. Patients and clinicians completed surveys and clinical assessments at baseline, Week-8 (timeframe for main endpoints) and Week-24. Patient’s self-reported satisfaction and clinician satisfaction with tirbanibulin treatment’s ability to improve ‘how skin looks’ and ‘skin texture’ in the treated area at individual patient-level were assessed among study patients at Week-8 on a seven-point adjectival response scale of 1 (extremely dissatisfied) – 7 (extremely satisfied). Results: A total of 290 patients with AKs completed the study assessments at Week-8 (female: 31.38%; history of skin cancer: 61.72%; Fitzpatrick skin type: I: 7.59%, II: 71.38%, III: 18.62%, IV: 1.38%, V: 1.03%). Patient self-reported skin-texture at baseline was – dry: 39.66%, smooth: 47.59%, rough: 19.66%, bumpy: 18.62%, scaly: 35.17%, blistering/peeling: 6.55%. All patients (100%) completed their 5-day once-daily treatment course. At Week-8, 75.86% & 78.97% of the patients and clinicians respectively reported extremely/very/satisfied with tirbanibulin’s ability to improve ‘how skin looks’, while 14.14% & 14.14% respectively reported somewhat satisfied, and 10.00% & 6.55% respectively reported extremely/very/dissatisfied. At Week-8, 74.83% & 80.69% of patients and clinicians respectively reported extremely/very/satisfied with tirbanibulin’s ability to improve their ‘skin texture’, while 15.52% & 12.41% respectively reported somewhat satisfied, and 9.65% & 6.55% respectively reported extremely/very/dissatisfied. Conclusion: A majority of patients with AKs and their clinicians reported satisfaction with the ability of 5-day treatment course of tirbanibulin to improve ‘how skin looks’ or ‘skin texture’ in the tirbanibulin-treated area, at Week-8.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46288563","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":"Five Years Later: Continuing Disparity in the Geographic Density and Distribution of U.S. Dermatologists","authors":"Christopher Nguyen, Q. Nguyen, Kyle C. Lauck, Adelaide Hebert","doi":"10.25251/skin.7.3.9","DOIUrl":"https://doi.org/10.25251/skin.7.3.9","url":null,"abstract":"Objectives: A discrepancy exists in the geographical distribution of dermatologists across the United States (US). The aim of this study was to reexamine the current geographical density of dermatologists to describe any changes compared to date from 5 and 12 years ago. \u0000Methods: Membership data from the 2021 American Academy of Dermatology (AAD) database were retrieved to characterize the distribution of dermatologists in 3-digit zip code areas. \u0000Results: Out of 712 populated zip codes with dermatologists, 510 (71.6%) had less than 4 dermatologists per 100,000, as compared to 515 (72.3%) in 2016 (– 0.19% CAGR). The dermatologist density of the 100 most populated areas (M = 4.5 dermatologists per 100,000, SD = 3.3) and 100 least populated areas (M = 1.6 dermatologists per 100,000, SD = 6.2) were significantly different (P < 0.0001). \u0000Conclusion: This analysis provides continued trends to compare to previous studies performed in 2016 and 2009. The highest and lowest density areas were similar to results from previous studies. The results indicate an enduring and significant maldistribution of dermatologists in the US.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" May","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41251564","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":"Impact of Actinic Keratosis on patient-reported AK symptoms, emotions and functioning measured using Skindex-16, among patients with Actinic Keratosis administered tirbanibulin in real-world community practices across the U.S. (PROAK Study)","authors":"D. Rigel, M. Lebwohl, T. Schlesinger, A. Armstrong, B. Berman, N. Bhatia, J. D. Del Rosso, L. Kircik, Vishal Patel, Siva Narayanan, V. Koscielny, I. Kasujee","doi":"10.25251/skin.7.supp.212","DOIUrl":"https://doi.org/10.25251/skin.7.supp.212","url":null,"abstract":"Objectives: Actinic Keratosis (AK) has been shown to negatively affect emotional functioning and skin-related quality of life of patients. Impact of tirbanibulin treatment in alleviating AK disease burden in patients with AKs is not adequately understood. Objective of the analysis is to evaluate changes in patient-reported AK symptoms, emotions, and functioning, among patients with AKs treated with tirbanibulin in community practices across the U.S. Methods: A single-arm, prospective cohort study (PROAK) was conducted among adult patients with AKs on the face or scalp who were newly initiated with tirbanibulin treatment in real-world community practices in the U.S, as part of usual care. Patients and clinicians completed surveys and clinical assessments at baseline, week-8 (timeframe for main endpoints) and week-24. Skindex-16, completed at baseline and week-8, is a 16-item survey with 3 domains: symptoms (items 1-4), emotions (items 5-11) and functioning (items 12-16), with each item scored on a seven-point adjectival response scale, with a potential score of 0 (never bothered) to 6 (always bothered). Changes from baseline in proportion of patients reporting a score of 0 or 1 (never or least bothered; i.e., least disease burden) was analyzed for all Skindex-16 items at week-8. Results: A total of 290 patients with AKs completed the study assessments at week-8 (female: 31.38%; history of skin cancer: 61.72%; Fitzpatrick skin type: I: 7.59%, II: 71.38%, III: 18.62%, IV: 1.38%, V: 1.03%). Patient self-reported skin-texture was – dry: 39.66%, smooth: 47.59%, rough: 19.66%, bumpy: 18.62%, scaly: 35.17%, blistering/peeling: 6.55%. Within symptoms domain of Skindex-16 related to itching, burning/stinging, hurting, and irritation, proportion of patients reporting “never or least bothered” increased significantly for each item at week-8 (p<0.0001). Within emotions domain of Skindex-16 related to persistence of condition, worries about skin, appearance, frustration, embarrassment, being annoyed, and feeling depressed, proportion of patients reporting “never or least bothered” increased significantly for each item at week-8 (p<0.0001). Within functioning domain of Skindex-16 related to interactions with others, desire to be with others, show affection, effect on daily activities, and effect on work or enjoyable activities, proportion of patients reporting “never or least bothered” increased significantly for each item at week-8 (p<0.0001). Conclusion: Patients with AKs who used once-daily tirbanibulin treatment for 5-days reported a significant reduction in the AK burden, as indicated by the improvement in AK symptoms and emotional/functional impact, at week-8.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46336036","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":"Blastomycosis-Like Pyoderma in a 59-year-old Male with Type 2 Diabetes Mellitus","authors":"Michela Salusti-Simpson, Hannah Porter, Dustin L Taylor, Evan W. Piette","doi":"10.25251/skin.7.3.17","DOIUrl":"https://doi.org/10.25251/skin.7.3.17","url":null,"abstract":"Blastomycosis-like pyoderma (BLP) is a rare cutaneous disorder that results from an exaggerated response to a bacterial infection, most commonly Staphylococcus aureus. There are a variety of reported predisposing factors, including diabetes, obesity, leukemia, primary immunodeficiency, and immunomodulatory therapy. Clinical and histopathological findings of BLP can be quite disparate, often resulting in a delay in diagnosis. We report here a case of a man who presented with an enlarging verrucous nodule of his neck, and was subsequently diagnosed with BLP. The purpose of sharing this case is to contribute to the existing literature of this rare disease by highlighting a unique presentation.","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46790908","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":"Early Insights into the Characteristics of Tralokinumab Patients in a Real-World Setting in the United States","authors":"R. Chovatiya, S. Balu, Yestle Kim, Amanda G. Althoff, L. Rasouliyan","doi":"10.25251/skin.7.supp.205","DOIUrl":"https://doi.org/10.25251/skin.7.supp.205","url":null,"abstract":"","PeriodicalId":74803,"journal":{"name":"Skin (Milwood, N.Y.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48358027","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}