Peter Foley MBBS, BMedSc, MD, FACD, Patrick D. Mahar MBBS, LLB, GDLP, MBA, MDerm, PhD, DMedSc, FACD, Saxon D. Smith MBBS, MHL, PhD, GAICD, FAMA, IFAAD, FACD, Monisha Gupta MBBS, MD, FACD, Nicholas Manuelpillai MBBS, BEng, BCom, MPH, David Orchard MBBS, FACD, Li-Chuen Wong MBBS, FACD, John C. Su MBBS, MEpi, FACD, Amelia James BSc, MD, Gayle Fischer MBBS, FACD, MD, Gillian Marshman MBBS, FACD, Morton Rawlin MBBS, FRACGP, Murray Turner LLB, BArts(Rec), Emma King RN, Robyn Kennedy RN, Christopher Baker MBBS, FACD, FRCP
{"title":"Australian consensus: Treatment goals for moderate to severe psoriasis in the era of targeted therapies – Considerations for paediatric patients","authors":"Peter Foley MBBS, BMedSc, MD, FACD, Patrick D. Mahar MBBS, LLB, GDLP, MBA, MDerm, PhD, DMedSc, FACD, Saxon D. Smith MBBS, MHL, PhD, GAICD, FAMA, IFAAD, FACD, Monisha Gupta MBBS, MD, FACD, Nicholas Manuelpillai MBBS, BEng, BCom, MPH, David Orchard MBBS, FACD, Li-Chuen Wong MBBS, FACD, John C. Su MBBS, MEpi, FACD, Amelia James BSc, MD, Gayle Fischer MBBS, FACD, MD, Gillian Marshman MBBS, FACD, Morton Rawlin MBBS, FRACGP, Murray Turner LLB, BArts(Rec), Emma King RN, Robyn Kennedy RN, Christopher Baker MBBS, FACD, FRCP","doi":"10.1111/ajd.14303","DOIUrl":"10.1111/ajd.14303","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment goals have been established in Australia to facilitate the management of adults with moderate to severe psoriasis. The Australasian College of Dermatologists sought to determine if and how these adult treatment goals could be modified to accommodate the needs of paediatric and adolescent patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A modified Delphi approach was used. Comprehensive literature review and guideline evaluation resulted in the development of statements and other questions to establish current clinical practices. Two rounds of anonymous voting were undertaken, with a collaborative meeting held in between to discuss areas of discordance. Overall, consensus was defined as achievement of ≥75% agreement in the range 7–9 on a 9-point scale (1 strongly disagree; 9 strongly agree).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Consensus was achieved on 23/29 statements in round 1 and 17/18 statements in round 2. There was a high level of concordance with treatment criteria in the adult setting. The limitations of applying assessment tools developed for use in adult patients to the paediatric setting were highlighted. Treatment targets in the paediatric setting should include objective metrics for disease severity and psychological impact on the patients and their family, and be based on validated, age-appropriate tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While the assessment, classification and management of moderate to severe psoriasis in paediatric patients aligns with metrics established for adults, it is vital that nuances in the transition from childhood to adolescence be taken into account. Future research should focus on psoriasis severity assessment scales specific to the paediatric setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 6","pages":"e134-e144"},"PeriodicalIF":2.2,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140915897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sha Jin MMed, Yige Zhao MMed, Shiwen Wang MMed, Panpan Wang MMed, Chenyu Tang MMed, Mengyan Zhu MMed, Ping Wang PhD
{"title":"Phenotypic heterogeneity of mycosis fungoides cells leads to the difficulties in determining tumour origin","authors":"Sha Jin MMed, Yige Zhao MMed, Shiwen Wang MMed, Panpan Wang MMed, Chenyu Tang MMed, Mengyan Zhu MMed, Ping Wang PhD","doi":"10.1111/ajd.14304","DOIUrl":"10.1111/ajd.14304","url":null,"abstract":"<p>Mycosis fungoides (MF) is a low-grade malignant cutaneous T-cell lymphoma that originates from memory T cells. It typically follows a unique and relatively indolent disease course. MF is used to be characterized by a tissue-resident memory T cell (TRM) phenotype, although recent molecular research has revealed its complexity, casting doubt on the cell of origin and the TRM-MF paradigm. Recent clonal heterogeneity studies suggest that MF may originate from immature early precursor T cells. During development, the tumour microenvironment (TME) influences tumour cell phenotype. The exact origin and development trajectory of MF remains elusive. Clarifying the origin of MF cells is vital for accurate diagnosis and effective treatment.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"e114-e116"},"PeriodicalIF":2.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897098","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":"Rosacea","authors":"","doi":"10.1111/ajd.14288","DOIUrl":"10.1111/ajd.14288","url":null,"abstract":"<p>Miranda Wallace<sup>1</sup>; <span>Nancy</span> <span>Todes-Taylor</span><sup><span>2</span></sup>; Margot Whitfeld<sup>3</sup></p><p><sup><i>1</i></sup><i>Pacific Dermatology, St Leonards, New South Wales, Australia;</i> <sup><i>2</i></sup><i>St Leonards Dermatology & Laser, St Leonards, New South Wales, Australia;</i> <sup><i>3</i></sup><i>Department of Dermatology, St Vincent's Hospital, Sydney, New South Wales, Australia</i></p><p><b>Aim:</b> Neurogenic rosacea is a form of rosacea due to neurogenic dysregulation and is characterised by severe facial erythema, burning, stinging and pain sometimes out of proportion to the degree of flushing. It is an uncommon, and often debilitating condition with severe effect on quality of life, and often refractory to traditional rosacea therapies. The intradermal microinjection technique of injecting diluted onabotulinum toxin A into the involved facial pattern can produce a significant improvement in the degree of both flushing and pain, where other therapies have failed.</p><p><b>Methods:</b> A 37-year-old female with long history of facial flushing, burning skin of the cheeks, forehead and chin and conjunctival hyperaemia, was diagnosed with a combination of neurogenic and ocular rosacea. She had previously failed therapies including topical metronidazole, brimonidine, ivermectin, oral doxycycline, beta blockers, alpha blockers, mirtazapine, amitriptyline and vascular laser therapy. In addition, patch testing was performed as well blood evaluation to rule out alternative diagnoses. The onabotulinum toxin A (1.67 units per 0.1 mL) diluted in saline, was injected using multiple sites approximately 1 cm apart, and approximately 0.05 mL per injection site, with 25 units in total used over the upper forehead, cheeks, upper lip and chin areas, which were areas most effected by erythema. An additional 14 IU onabotulinum toxin A (100 IU diluted with 2.5 mL saline) diluted was injected into the glabellar complex.</p><p><b>Results:</b> Improvement of symptoms were noticed by the patient within 2 weeks of the first treatment, and a second treatment, 4 months later was requested because of its efficacy. The Rosacea-specific Quality-of-Life instrument (RosQol) showed improvement from a score of 76 to 58 four months after the first treatment.</p><p><b>Conclusion:</b> Neurogenic rosacea is difficult to treat, and dilute intradermal onabotulinum toxin A, may be beneficial therapy to consider in refractory cases.</p><p><span>James Fuller</span><sup><span>1</span></sup>; Cathal O'Connor<sup>2</sup>; Michelle Murphy<sup>2</sup></p><p><sup><i>1</i></sup><i>Skin Health Institute, Melbourne, Victoria, Australia;</i> <sup><i>2</i></sup><i>South Infirmary Victoria and University Hospital, Cork, Ireland</i></p><p><b>Aim:</b> Rosacea is a common chronic inflammatory skin disease with a complex aetiology and major psychological impact. Patients with rosacea have higher incidences of embarrassment, social anxiety, depressio","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 S1","pages":"120-121"},"PeriodicalIF":2.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14288","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ethics and Professionalism","authors":"","doi":"10.1111/ajd.14280","DOIUrl":"10.1111/ajd.14280","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 S1","pages":"45-46"},"PeriodicalIF":2.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current and Future Dermatology","authors":"","doi":"10.1111/ajd.14278","DOIUrl":"10.1111/ajd.14278","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 S1","pages":"38-41"},"PeriodicalIF":2.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Climate Change and Skin Health","authors":"","doi":"10.1111/ajd.14275","DOIUrl":"10.1111/ajd.14275","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 S1","pages":"29"},"PeriodicalIF":2.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140897158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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