Australasian Journal of Dermatology最新文献

{"title":"Safety and Efficacy of Non-Steroidal Topical Aryl Hydrocarbon Receptor Agonists for the Treatment of Atopic Dermatitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.","authors":"Martin Cevallos-Cueva, Carlos Alberto Monteiro Leitão Neto, Devanie Martani, Laura Ghanem, Camila Almeida Sardinha, Daniela Lucía Mendoza-Millán, Cristina Sicorschi Gutu, Victor Barreiros Pungirum, Peter Chien","doi":"10.1111/ajd.14485","DOIUrl":"10.1111/ajd.14485","url":null,"abstract":"<p><strong>Background: </strong>Current first-line topical treatments for atopic dermatitis (AD) are often limited by concerns related to age, systemic absorption, especially when applied to large body surface areas or under maximal usage conditions and undesirable adverse events (AEs), highlighting the need for alternative therapies.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of seven randomised controlled trials (RCT) comparing topical aryl hydrocarbon receptor agonists (TAHRA), including tapinarof and benvitimod cream, to vehicle at different concentrations and application frequencies in patients with AD, which evaluated outcomes such as Investigator Global Assessment (IGA) scores/Validated Investigator's Global Assessment (vIGA), the Eczema Area and Severity Index (EASI-75), change from baseline in body surface area (BSA) and pruritus score (PS) and safety profiles.</p><p><strong>Results: </strong>A total of 1631 patients, 1086 received TAHRA, while 545 received vehicle. Overall, TAHRA led to a significant improvement in the IGA/vIGA scores (RR 2.38; 95% CI 1.68 to 3.37; p < 0.00001), EASI-75 (RR 2.94; 95% CI 2.07 to 4.17; p < 0.00001). Similar findings were observed for mean change from baseline in BSA% (MD -6.08; 95% CI -8.00 to -4.16; p < 0.00001), and PS (Std MD -0.90; 95% CI -1.41 to -0.39; p = 0.0006). The incidence of AEs was significantly higher in the TAHRA group (RR 1.48; 95% CI 1.19 to 1.85; p = 0.0005). We found no significant difference in the incidence of serious adverse events (SAEs) (RR 1.51; 95% CI 0.34 to 6.64; p = 0.59). Treatment-emergent adverse events (TEAEs), such as folliculitis, were more frequent in the TAHRA group (RR 8.06; 95% CI 2.75 to 23.60; p = 0.0001).</p><p><strong>Conclusion: </strong>Our findings support the efficacy of TAHRA among different metrics with minimal and tolerable AEs and its use as a valuable new non-steroidal option for the treatment of AD.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":"e249-e259"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794584","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":"Informed Consent for Artificial Intelligence in Dermatology: Practicalities and Pitfalls.","authors":"Seán O'Malley, Jessica Gale","doi":"10.1111/ajd.14543","DOIUrl":"10.1111/ajd.14543","url":null,"abstract":"<p><p>Informed consent is a foundational cornerstone of modern healthcare interventions, and the use of artificial intelligence systems is not free from this requirement. A variety of contexts dictate how consent is approached and the level of explanation demanded for artificial intelligence employment, including the use of patient data for clinician support, diagnostics, model training and even autonomous decision making. How these systems are implemented will dictate the burden of detail to be provided, and as such, a robust informed consent process in artificial intelligence utilisation is critical for well-informed patient decisions, which develops trust within such systems in a modern healthcare landscape.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":"296-298"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233032","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":"Consensus on the Use of JAKinibs for Atopic Dermatitis in Australia and New Zealand. An eDelphi by the Australasian Medical Dermatology Group.","authors":"Marius Rademaker, Peter Foley, Katherine Armour, Christopher Baker, Kurt Gebauer, Monisha Gupta, Patrick Ireland, Harriet Kennedy, Gillian Marshman, Erin McMeniman, Diana Rubel, Diana Slape, John Sullivan, Matthew Verheyden, Li-Chuen Wong","doi":"10.1111/ajd.14525","DOIUrl":"10.1111/ajd.14525","url":null,"abstract":"<p><p>With its chronicity and varied symptomatology, moderate to severe atopic dermatitis (AD) remains a significant challenge for both patients and health care professionals. Novel targeted therapies, including the JAK inhibitors (JAKi) offer significant hope. There are many systematic reviews and meta-analyses of the use of JAKi for the management of atopic dermatitis, but few offer practical advice for the clinician. The aim of this consensus development was to place the current literature for JAKi use in atopic dermatitis within the clinical context of practice in Australasia. The Australasian Medical Dermatology Group (AMDG) reviewed the evidence for the use of JAKi in the management landscape of atopic dermatitis, adding in their cumulative experience, and used an eDelphi process to agree on best practice. In the first round of 133 eDelphi clinical practice statements, consensus was achieved in 117 (88%-complete 27.8%, close 60.1%), with no consensus in 16 (12.0%) of the statements. The 16 clinical practice statements that did not reach consensus were reviewed and revised to 15 statements and then subjected to a second round: complete consensus was achieved in 5/15 statements, close consensus in 6/15, and no consensus in 4/15. Over the two eDelphi rounds, consensus was achieved in 128/132 (97%-complete 32%, close 64%) and no consensus in 4/132 (3%). Statements regarding screening for prior varicella infection, age-appropriate cancer screening intervals, and management of flares did not reach full consensus. This study highlights areas where further research is needed to assist practicing dermatologists in safe prescribing and management of atopic dermatitis with JAK inhibitors.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":"e287-e296"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952919","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":"Lichen Planus Follicularis Tumidus.","authors":"A I Oloruntoba, Saurabh Prakash, Ryan Toholka","doi":"10.1111/ajd.14545","DOIUrl":"10.1111/ajd.14545","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":"e316-e318"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574756","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":"Outside-In Immunity: Rethinking Autoimmunity in Vulvar Lichen Sclerosus.","authors":"Ankan Gupta","doi":"10.1111/ajd.14536","DOIUrl":"https://doi.org/10.1111/ajd.14536","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 5","pages":"e319-e320"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803334","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":"Familial Frontal Fibrosing Alopecia Occurs Early in Daughters With Affected Mothers: A Case Report and a Review of the Literature.","authors":"Adrienne Oxenham, Annabel Stevenson","doi":"10.1111/ajd.14463","DOIUrl":"10.1111/ajd.14463","url":null,"abstract":"<p><p>Frontal fibrosing alopecia (FFA) is a form of cicatricial alopecia that is being increasingly diagnosed in recent years. It predominantly affects post-menopausal women of various ethnic backgrounds, but cases have also been reported in pre-menopausal women and rarely in men. Eleven familial cases of FFA have been published in the literature, with some authors raising speculation about potential genetic predisposition or shared exposure to environmental factors as triggers for the condition. Despite this, there remains a lack of detailed characterisation of the clinical features specific to familial cases of FFA. In this report, we aim to contribute to the understanding of FFA by presenting the first Australian case of familial FFA involving a mother and her daughter, while also attempting to define the clinical distinguishing features in familial FFA and sporadic FFA.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":"247-257"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750494","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":"The Incidence and Management of TNF-α Inhibitor Induced Paradoxical Psoriasis in Children With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.","authors":"James Gaston, Tai Ermongkonchai, Andrew Chen, Senhong Lee, Francis Yi Xing Lai","doi":"10.1111/ajd.14526","DOIUrl":"10.1111/ajd.14526","url":null,"abstract":"<p><p>Paradoxical psoriasis is a well-described phenomenon following treatment with Tumour Necrosis Factor alpha (TNF-α) inhibitors in adult patients with Inflammatory Bowel Disease (IBD). The incidence and optimal treatment strategies are not well described in children with IBD. This subgroup of patients is disproportionately impacted by TNF-α inhibitor-induced psoriatic eruptions. Our systematic review and meta-analyses aims to describe the incidence, presentation, and management options for TNF-αinhibitor-induced psoriasis in paediatric patients with IBD. A systematic literature search was conducted using Medline, Embase and Cochrane databases for studies published up to February 2025. Retrospective cohort studies (n = 16), prospective cohort study (n = 1), and a cross-sectional study (n = 1) met inclusion criteria. Studies focusing on patients > 18 years or TNF-α inhibitors used for non-IBD conditions were excluded. A total of 3349 paediatric patients with IBD treated with TNF-α inhibitors were analysed, with 255 (7.6%) developing paradoxical psoriasis. Meta-analysis of 13 studies meeting sample size criteria yielded a pooled incidence of 6.8% (95% CI: 0.04-0.10). Infliximab (IFX) accounted for 151 (79.1%) of cases, whereas adalimumab (ADA) contributed to 40 (20.9%) cases. The median time to clinical eruption was 15.0 months (12.0-18.0). Among affected patients, 22.3% (51/229) discontinued their prescribed TNF-α inhibitor and 5.7% (13/229) were subsequently switched to an alternative TNF-α inhibitor. Ustekinumab (UST) was the most common non-TNF-α alternative (14/94). TNF-α inhibitor-induced psoriasis is a common adverse effect in paediatric IBD, with a significant proportion of cases necessitating treatment discontinuation. Long-term outcomes following a switch to non-TNF-α biologics remain unclear, highlighting the need for further prospective studies.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":"e260-e270"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118706","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":"Sun Safety Policy Implementation in Australian Primary Schools.","authors":"Katherine Lissner, Annabel Stevenson","doi":"10.1111/ajd.14461","DOIUrl":"10.1111/ajd.14461","url":null,"abstract":"<p><strong>Background/objectives: </strong>Current SunSmart policy in Australia is implemented and reviewed by the Cancer Council using self-reported survey data.</p><p><strong>Methods: </strong>Researchers conducted an external assessment of the implementation of sun safety policies in Australian primary schools by conducting a national survey with questions constructed based on the SunSmart policy. Multivariable binary logistic regressions were performed to understand the relationships between the various sun-safety activities and school characteristics.</p><p><strong>Results: </strong>We hypothesised that schools with a higher ultraviolet (UV) exposure rating would perform better due to higher perceived risk. This was true for year-round uniform policy and presence of outdoor sails. Use of sunscreen in Australian schools remains inadequate. Students at more advantaged schools were 2.1 times more likely to use sunscreen, potentially demonstrating a relationship between financial access or awareness, providing an avenue for future funding decisions. Use of sun-protective eyewear remains insufficient, with only 11.1% of schools encouraging use, but Catholic school students are twice as likely to wear sunglasses. Schools in extreme UV areas had the lowest odds ratio of sunglasses use, highlighting a clear target for future intervention. Other important differences in school type were found, including that independent school students have a 58% lower likelihood of wearing SunSmart adherent uniforms.</p><p><strong>Conclusions: </strong>We found statistically significant inequalities in sun safety behaviours in different school types in Australia, providing utility for future funding and policy decisions.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":"268-278"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690992","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":"Ingrown Toenail With Hypertrophic Skin Bridging.","authors":"Karalikkattil T Ashique, Puravoor Jayasree, Feroze Kaliyadan","doi":"10.1111/ajd.14563","DOIUrl":"10.1111/ajd.14563","url":null,"abstract":"<p><p>Onychocryptosis, or ingrown toenail (IGTN), is a painful condition commonly resulting from improper nail trimming or hypertrophic lateral nail folds. We present a rare variant in which the entire distal nail plate becomes embedded within markedly hypertrophic nail folds, forming a tunnel-like structure. This case was successfully managed with radiofrequency excision followed by chemical matricectomy. This combined approach proved highly effective, offering excellent outcomes with minimal complications.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":"299-300"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574755","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":"Emerging Terbinafine Resistant Trichophyton Dermatophytosis, Testing Options and Alternative Treatments: A Systematic Review.","authors":"Thuvarahan Jegathees, Zachary P Holmes, Catherine Martin, Cindy Kalai, Catherine Voutier, Denis Spelman, Gemma Robertson, Johannes S Kern","doi":"10.1111/ajd.14575","DOIUrl":"https://doi.org/10.1111/ajd.14575","url":null,"abstract":"<p><p>Dermatophytosis is a common superficial fungal infection of the skin, most often caused by dermatophytes from the Trichophyton genus. Terbinafine, which inhibits squalene epoxidase (SQLE), is widely used as first line treatment. However, resistance to terbinafine is increasing globally, including recent reports in Australia, with origins suspected to trace back to South Asia. Antifungal susceptibility testing is not routinely available in Australia, and globally, there are no standardised breakpoints for traditional culture-based methods. Although SQLE gene mutations have been associated with terbinafine resistance, a major research gap exists in the clinical interpretation of these mutations due to a lack of correlation between MIC values, genetic mutations and clinical treatment outcomes. This gap hampers the ability to guide clinical decision-making. Therefore, our objective was to assess the global prevalence of terbinafine-resistant Trichophyton infections, identify the most clinically relevant resistance testing methods, and determine effective alternative treatment options. The study was designed by systematic review. Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews (CDSR), Cochrane's Trials database (CENTRAL), Global Health (CABI), Trials registries, along with Google Scholar and Web of Science (WoS) for the tracking of included articles. Published human studies in English from 2000 to 2023 of Terbinafine-resistant Trichophyton Dermatophytosis with confirmed antifungal susceptibility tests and genotyping of dermatophytes, as well as details of effective alternative treatments. Identified cases were independently screened by two authors on the basis of predetermined criteria. Thirty four studies reported 743 samples for which mutation data of the SQLE gene and minimum inhibitory concentration (MIC) were available. Twenty three studies reported on 149 patients who had used terbinafine with available MIC data. Of these, 94 cases demonstrated evidence of clinical resistance to terbinafine with confirmed SQLE genotyping and MIC data. Seven studies reported on 13 cases of clinical resistance to terbinafine with a reported MIC and a successful alternative therapy. There are no published MIC breakpoints for terbinafine resistance in antifungal resistance testing, creating significant challenges for clinical interpretation. This study suggests that an estimate of a provisional MIC threshold for resistance is calculated to be 1.69 μg/mL. Importantly, SQLE mutation data, particularly the presence of F397L, L393F and A448T shows a robust association with clinical resistance to terbinafine (odds ratio: 7.58; 14.0, 7.78, respectively). Routine SQLE mutation testing in cases of suspected terbinafine-resistant dermatophytosis could enhance diagnostic accuracy and inform more effective, timely treatment decisions. Identifying specific mutations may guide clinicians in selecting alternative antifungal agents earlier in the treatment","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697503","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}