Australasian Journal of Dermatology最新文献

{"title":"Tuberculosis reactivation following apremilast therapy for psoriasis: Time to consider routine TB screening?","authors":"Lucinda Adams, Emma L. Smith, Dev Tilakaratne, Vicki Krause","doi":"10.1111/ajd.14364","DOIUrl":"https://doi.org/10.1111/ajd.14364","url":null,"abstract":"Apremilast is a relatively new oral treatment for psoriasis, which reduces expression of pro‐inflammatory factors, including tumour necrosis factor‐α (TNFα), critical to the immune control of <jats:italic>Mycobacterium tuberculosis</jats:italic> infection. In randomised controlled trials (RCTs) for apremilast no new cases of active tuberculosis (TB) were identified, thus, screening for latent TB infection (LTBI) is not currently recommended prior to apremilast initiation. We describe a case of <jats:italic>M.tuberculosis</jats:italic> reactivation shortly after commencement of apremilast for psoriasis. We are recommending clinicians perform LTBI risk assessment in all patients, and appropriate LTBI screening in select populations prior to apremilast initiation.","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142226885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of oral benzodiazepines for patient anxiety associated with Mohs micrographic surgery: An Australian survey","authors":"Adam G. Harris, Simon Lee","doi":"10.1111/ajd.14361","DOIUrl":"https://doi.org/10.1111/ajd.14361","url":null,"abstract":"A survey of Mohs surgery specialists in Australia showed diazepam was the preferred agent and felt to be the safest oral benzodiazepine for perioperative anxiolysis.","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin health of Aboriginal children living in urban communities.","authors":"Bernadette M Ricciardo, Heather-Lynn Kessaris, Noel Nannup, Dale Tilbrook, Nadia Rind, Richelle Douglas, Jodie Ingrey, Jacinta Walton, Carol Michie, Brad Farrant, Eloise Delaney, S Prasad Kumarasinghe, Jonathan R Carapetis, Asha C Bowen","doi":"10.1111/ajd.14363","DOIUrl":"https://doi.org/10.1111/ajd.14363","url":null,"abstract":"<p><strong>Background: </strong>Skin concerns are frequent among urban-living Aboriginal children, yet specialist dermatology consultations are limited with studies highlighting the need for improved cultural security. Through newly established paediatric dermatology clinics at two urban Aboriginal Community Controlled Health Organisations (ACCHOs), we aimed to describe clinic and patient data, including disease frequencies and associations, to inform dermatology service provision and advocacy.</p><p><strong>Methods: </strong>A prospective cohort study of Aboriginal children and young people (CYP, 0-18 years) attending Aboriginal Health Practitioner (AHP) co-ordinated paediatric dermatology clinics at two urban ACCHOs.</p><p><strong>Results: </strong>Data were collected from 32 clinics over 19 months, with 335 episodes of care and a mean attendance rate of 74%. From 78 new patients, 72 (92%) were recruited into the study, only one of whom had previously received dermatologist assessment. Eczema, tinea or acne accounted for 47% (34/72) of referrals, and 60% of patients received their first appointment within 4 weeks of referral. In 47/72 (65%) consultations, the GP referral and dermatologist diagnosis concurred. The most frequent diagnoses (primary or secondary) at first consultation were atopic dermatitis (26%, 19/72), dermatophyte infections (25%, 18/72), acne (21%, 15/72), bacterial skin infections (18%, 13/72) and post-inflammatory dyspigmentation (18%, 13/72). Three categories of the 2022 Australasian College of Dermatologists curriculum (infections, eczema/dermatitis, pigmentary disorders) accounted for 59% of all diagnoses.</p><p><strong>Conclusions: </strong>This study highlights the specialist dermatology needs of urban-living Aboriginal CYP. ACCHO-embedded dermatology clinics co-ordinated by AHPs demonstrated benefits for Aboriginal CYP in accessing care. Opportunities to embed dermatology practice within ACCHOs should be prioritised.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of psychiatric disorders in finasteride users with benign prostatic hyperplasia and androgenetic alopecia: A population-based case-control study.","authors":"Anna Lyakhovitsky, Boaz Amichai, Eran Galili, Arnon Cohen, Khalaf Kridin, Zvi Segal, Doron Netzer","doi":"10.1111/ajd.14359","DOIUrl":"https://doi.org/10.1111/ajd.14359","url":null,"abstract":"<p><strong>Background: </strong>There is a long-standing debate if finasteride, a medication used to treat benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA), can cause psychiatric side effects.</p><p><strong>Objective: </strong>The goal of this large-scale population-based study was to determine whether finasteride therapy for BPH and AGA is associated with the emergence of mental health conditions.</p><p><strong>Methods: </strong>This observational case-control study compared the data from patients with BPH who received finasteride 5 mg daily and patients with AGA who received finasteride 1 mg daily with age- and gender-matched controls. The incidence of psychological health outcomes such as depression, anxiety, neuroses, bipolar disorder, schizophrenia, psychoses and alcohol abuse within 2 years of the initiation of finasteride therapy has been evaluated and compared between the finasteride groups and controls.</p><p><strong>Results: </strong>The BPH group included 307 men with a mean age of 61.5 (±17.4) years and 1218 controls. Mental health outcomes recorded in 2.3% of the patients, with no significant increase in rate when compared to controls. The AGA group consisted of 23,227 men with a mean age of 31.4 (±10.3) years and 39,444 controls. Only One percent of AGA patients developed psychiatric disorders. In comparison to controls, patients with AGA had higher rates of anxiety and depression (0.6% vs. 0.4%, p = 0.04, and 0.5% vs. 0.4%, p = 0.007, respectively). In multivariate regression models, finasteride was found as one of the risk factors for anxiety (OR 1.449, p = 0.002) and depression (OR 1.439, p = 0.003) when stratified to age, sector, socioeconomic status and comorbidities.</p><p><strong>Conclusions: </strong>According to our research, finasteride users had a very low rate of adverse mental health effects, with no increase in psychological sequelae in BPH patients and a slight increase in anxiety and depression in AGA patients.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatological care of gender-diverse patients in Australia.","authors":"Roy Kingsley Wong, Jenny Harrington, Annabel Irene Stevenson","doi":"10.1111/ajd.14360","DOIUrl":"https://doi.org/10.1111/ajd.14360","url":null,"abstract":"<p><p>In recent years, there has been an increasing recognition of the unique healthcare needs of gender-diverse patients in Australia. With the continuous growth of referrals to gender health services, there is an increased demand for specialised dermatological care. There is still a significant knowledge gap and a lack of guidelines specifically tailored to this patient group. In this article, we will provide a brief overview of the journey of Transgender and Gender Diverse (TGD) individuals as they embark on psychological and pharmacologic treatment for gender dysphoria in Australia. We endeavour to contribute to the existing body of knowledge by examining the evidence surrounding the treatment of skin, hair and nail issues for TGD patients. This article will outline how dermatologists can assist in the care of the gender-diverse patient. Although puberty blockade (stage 1 treatments) has minimal dermatological impact, gender-affirming pharmacotherapy (stage 2 treatments) can lead to many dermatological issues including acne, patterned hair loss (PHL) and dermatitis. The dermatologist may also play a role in stage 3 treatments which include surgical or procedural interventions for gender affirmation.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of biologic drugs in children or adolescents with atopic dermatitis: A systematic review and meta-analysis of randomized controlled trials.","authors":"Ana Clara Felix de Farias Santos, Fernanda Valeriano Zamora, Lorhayne Kerly Capuchinho Scalioni Galvao, Nicole Dos Santos Pimenta, João Pedro Costa Esteves Almuinha Salles, Kélen Klein Heffel","doi":"10.1111/ajd.14358","DOIUrl":"https://doi.org/10.1111/ajd.14358","url":null,"abstract":"<p><p>Children and adolescents suffering from moderate-to-severe atopic dermatitis (AD) face a significant disease burden that greatly impacts their quality of life. Treatment options for AD are currently limited. To assess the safety and efficacy of biologic drugs, dupilumab, lebrikizumab, or tralokinumab, in improving outcomes in patients with moderate to severe inadequately controlled AD. We searched PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs) comparing dupilumab, lebrikizumab or tralokinumab to placebo in patients with AD. We computed odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs), random effects model was used and a p-value <0.05 was considered as statistically significant. We analysed data into Review Manager 5.4. A total of five RCTs and 973 patients were included, of whom 592 were prescribed a biologic drug. Compared with placebo, patients receiving a biologic drug had a greater improvement, achieved an Investigator Global Assessment (IGA) score of 0 or 1 (OR 5.05; 95% CI 3.08-8.29), Eczema Area and Severity Index (EASI) 75 (OR 6.87; 95% CI 4.71-10.02), EASI 50 (OR 8.89; 95% CI 6.18-12.78) and EASI 90 (8.30; 95% CI 4.81-14.31). The proportion of patients with 3 points or more (OR 6.56; 95% CI 4.34-9.90) or 4 points or more (OR 8.09; 95% CI 5.19-12.59) improvement from baseline in peak pruritus NRS was significantly higher with biologic drugs than placebo. There were no significant differences between groups regarding adverse events (OR 0.79; 95% CI 0.58-1.07), and conjunctivitis (OR 2.08; 95% CI 1.00-4.33). In this meta-analysis, dupilumab, lebrikizumab, and tralokinumab have shown significant improvements in signs, symptoms and quality of life in children or adolescents with moderate to severe AD. Larger studies may be needed to continue evaluating the safety and efficacy of these biologic drugs in this patient population.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic treatment outcomes in generalized pustular psoriasis of pregnancy: A systematic review.","authors":"YuFei Wang, ChaoJing Zhou, YiYun Hou, YaMei Gao, JiLiang Lu, ZhiQiang Yin","doi":"10.1111/ajd.14357","DOIUrl":"https://doi.org/10.1111/ajd.14357","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of the literature: The role of biologics and JAK inhibitors in vitiligo.","authors":"Rhiannon Russell, Benjamin S Daniel","doi":"10.1111/ajd.14353","DOIUrl":"https://doi.org/10.1111/ajd.14353","url":null,"abstract":"<p><p>Vitiligo is a chronic depigmenting disorder that significantly impacts the quality of life of patients. Though there have been significant advancements in targeted therapies in skin diseases such as psoriasis or eczema, the progress in the treatment of vitiligo has been slow, with minimal studies assessing the effect of biologics, though there has been recent evidence of the effectiveness of JAK inhibition. This paper reviews the published case reports and studies for the use of systemic targeted therapies including biologics and JAK inhibitors in vitiligo.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiovascular risk in bullous pemphigoid: Insights from a population-based study.","authors":"Khalaf Kridin, Rina Goychberg, Mouhammad Kridin, Niv Kafri, Masad Barhoum, Arnon D Cohen","doi":"10.1111/ajd.14355","DOIUrl":"https://doi.org/10.1111/ajd.14355","url":null,"abstract":"<p><strong>Background: </strong>The risk of life-threatening major cardiovascular outcomes among patients with bullous pemphigoid (BP) is inconsistent in the current literature.</p><p><strong>Objective: </strong>To evaluate the risk and prognostic outcomes of myocardial infarction (MI), cerebrovascular accident (CVA), peripheral vascular disease (PVD) and pulmonary embolism (PE) in patients with BP. We additionally aimed to explore the influence of different therapeutic approaches on the risk of these outcomes.</p><p><strong>Methods: </strong>A population-based retrospective cohort study was conducted to compare BP patients (n = 3924) with age-, gender- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of MI, CVA, PVD and PE. Adjusted hazard ratio (HR) and 95% confidence intervals (CI) were estimated by multivariate Cox regression analysis. Data were retrieved from Clalit Health Services' computerized database.</p><p><strong>Results: </strong>Relative to their matched controls, patients with BP were at an elevated risk of MI (fully-adjusted HR: 1.44; 95% CI: 1.14-1.81; p = 0.002), CVA (fully-adjusted HR: 1.24; 95% CI: 1.06-1.45; p = 0.007), PVD (fully-adjusted HR: 1.60; 95% CI: 1.27-2.03; p = 0.003) and PE (fully-adjusted HR: 1.72; 95% CI: 1.28-2.32; p < 0.008). Patients with BP experienced heightened risk of all-cause mortality in the presence of comorbid MI (fully-adjusted HR: 1.61; 95% CI: 1.44-1.81; p < 0.001), CVA (fully-adjusted HR: 1.70; 95% CI: 1.52-1.89; p < 0.001), PVD (fully-adjusted HR: 1.38; 95% CI: 1.20-1.58; p < 0.001) and PE (fully-adjusted HR: 1.44; 95% CI: 1.10-1.88; p = 0.007). The therapeutic approach utilized to manage BP did not significantly influence the risk of cardiovascular outcomes.</p><p><strong>Conclusions: </strong>BP is associated with an elevated risk of MI, CVA, PVD, PE and cardiovascular mortality. Primary, secondary and tertiary cardiovascular prevention measures should be implemented among patients with BP.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bullous pemphigoid in infancy.","authors":"Lois Zhang, Gloria Fong, Andrew Ming, Melanie Wong","doi":"10.1111/ajd.14354","DOIUrl":"https://doi.org/10.1111/ajd.14354","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}