Australasian Journal of Dermatology最新文献

{"title":"Systematic Review of Rare Major Adverse Cardiovascular Events Associated With the Treatment of Acne With Isotretinoin.","authors":"Timothy L Cowan, Madeleine Stark, Simona Sarmiento, Andrew Miller","doi":"10.1111/ajd.14424","DOIUrl":"https://doi.org/10.1111/ajd.14424","url":null,"abstract":"<p><p>Acne vulgaris is a common inflammatory condition that is often treated by dermatologists with isotretinoin. Isotretinoin has a number of effects on inflammatory pathways, with clear efficacy in managing acne vulgaris. There are also well-documented side effects of isotretinoin, including hyperlipidemia; however, the overall cardiovascular risk is unclear. This systematic review revealed low evidence for major adverse cardiovascular events associated with the use of isotretinoin in acne patients. Despite this low evidence, rare events may be associated and should still be considered when using isotretinoin in acne patients.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381525","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":"Upadacitinib for Chronic Actinic Dermatitis: A Case Report and Literature Review of JAK Inhibitor Use for Recalcitrant Disease.","authors":"Zachary Holmes, Conor Larney, Peter Foley, Chris Baker, Benjamin S Daniel","doi":"10.1111/ajd.14431","DOIUrl":"https://doi.org/10.1111/ajd.14431","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373520","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":"Spironolactone for the Treatment of Moderate to Severe Acne in Adult Women: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.","authors":"Chia Siang Kow, Dinesh Sangarran Ramachandram, Syed Shahzad Hasan, Kaeshaelya Thiruchelvam","doi":"10.1111/ajd.14428","DOIUrl":"https://doi.org/10.1111/ajd.14428","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to assess the efficacy and safety of spironolactone for moderate to severe acne in adult women by synthesising data from randomised controlled trials (RCTs). The meta-analysis demonstrated that spironolactone significantly increased the odds of treatment success, with a pooled odds ratio (OR) of 2.51 compared to placebo or doxycycline. This analysis supports spironolactone as a highly effective treatment for moderate to severe acne in adult women, particularly in hormonally driven cases. Its efficacy, combined with its role as an alternative to long-term antibiotic therapy, makes it a valuable option for acne management in women population.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254481","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":"Australian Sunscreens: The Price of Protection for Skin of Colour With Pigmentary Disorders.","authors":"Xiaozhun Hang, Davin Sui Lim","doi":"10.1111/ajd.14423","DOIUrl":"https://doi.org/10.1111/ajd.14423","url":null,"abstract":"<p><p>Australia experiences some of the highest ultraviolet radiation (UVR) levels globally, known for causing sunburn, skin cancers, photoageing and immunosuppression. While effects of UVA and UVB are well-studied, visible light (VL; 400-700 nm) is the driving force behind pigmentary disorders, especially in skin of colour (SOC) patients. Nearly 50% of Australians are affected, with significant impacts on appearance and psychological well-being. Tinted sunscreens containing iron oxides and pigmentary-grade titanium dioxide are the only effective options for blocking VL. However, Australia's stringent Therapeutic Goods Administration (TGA) regulations limit the availability of colour-matched tinted sunscreens, significantly impacting SOC patients. SOC patients may also underestimate their need for photoprotection, believing their skin provides sufficient natural protection. In dermatological practice, tailored sunscreen recommendations for darker skin tones may sometimes be overlooked. This review explores the barriers to effective treatment and the cost implications for SOC individuals suffering from pigmentary disorders in Australia. The goal is to guide both patients and dermatologists in making informed decisions on VL protection and skin tone matching.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188052","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":"Biosimilars for Australian Dermatologists.","authors":"Grace X Li, Mona Marabani, Deshan F Sebaratnam","doi":"10.1111/ajd.14427","DOIUrl":"https://doi.org/10.1111/ajd.14427","url":null,"abstract":"<p><p>Biosimilars offer the potential for substantial cost savings within the Australian healthcare system. This is particularly salient in dermatology, where biologics are used to treat chronic skin diseases and cost savings will be accrued throughout the life of a patient. However, uptake of biosimilars in clinical practice has been hindered by barriers including insufficient clinician education, concerns about safety and efficacy, and negative patient perception. Increased availability of biosimilars promotes long-term sustainability of the Pharmaceutical Benefits Scheme and may help maintain equitable access to healthcare across Australia.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188119","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":"Laryngeal Squamous Cell Carcinoma and Diathermy Plume.","authors":"Lachlan J Warren, Suren Krishnan","doi":"10.1111/ajd.14426","DOIUrl":"https://doi.org/10.1111/ajd.14426","url":null,"abstract":"<p><p>Plume from surgical diathermy systems is recognised as a hazard to healthcare providers but is often ignored during ambulatory care procedures. The development of a squamous cell carcinoma of the larynx in a dermatologist, despite the absence of recognised risk factors, prompted this review and recommendations for change in procedural practices.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078440","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":"Acneiform Eruption Secondary to Deucravacitinib: A Case Series and Review of the Literature.","authors":"Vanessa Tran, Celestine Wong, Senhong Lee, Michelle Rodrigues","doi":"10.1111/ajd.14425","DOIUrl":"https://doi.org/10.1111/ajd.14425","url":null,"abstract":"<p><p>Acneiform eruptions have been observed and reported in clinical trials for tyrosine kinase 2 (TYK2) inhibitors. However, data on their occurrence in real-world settings remain limited. This case series describes six patients, who developed acneiform eruptions following the initiation of deucravacitinib for chronic plaque psoriasis. Through this case series, we aim to shed further light into the clinical characteristics and potential risk factors for this side effect. Contrary to clinical trial data, we demonstrate high cessation rates of deucravacitinib following the development of acneiform eruption, due to the significant burden on quality of life. We highlight the need to identify risk factors to improve patient selection and allow adequate counselling or prophylactic treatments for these acneiform eruptions.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073559","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":"‘Psoriasis Punctata’: An Under-Recognised Clinical Phenotype of TNF-Alpha Inhibitor-Induced Psoriasis","authors":"Grace Im,&nbsp;Nidhi Kuchimanchi,&nbsp;Kira J. Dubester,&nbsp;Barrett J. Zlotoff,&nbsp;R. Hal Flowers","doi":"10.1111/ajd.14420","DOIUrl":"10.1111/ajd.14420","url":null,"abstract":"&lt;p&gt;Tumour necrosis factor (TNF)-alpha inhibitors are commonly used to treat numerous inflammatory conditions. Paradoxical psoriasiform eruptions (‘TNF inhibitor-induced psoriasis’) are well-recognised adverse effects and can manifest as plaque, guttate, inverse, pustular, scalp psoriasis, as well as psoriasiform eruptions [&lt;span&gt;1-3&lt;/span&gt;]. A small form of guttate psoriasis, termed here ‘psoriasis punctata’ has been seen routinely in our clinic. This morphology is underappreciated in literature. We aimed to characterise psoriasis punctata and compare its features with other subtypes of TNF-alpha-induced psoriasis.&lt;/p&gt;&lt;p&gt;Querying our institution's EMR system from 2004 to 2024, we identified 93 patients with TNF inhibitor-induced psoriasis. We collected data on demographics, the TNF inhibitor used, underlying inflammatory diseases, time to psoriasis onset after therapy initiation and lesion locations. Statistical analyses were performed using R, as shown in Table 1.&lt;/p&gt;&lt;p&gt;Among 93 patients with TNF inhibitor-induced psoriasis, 21 patients (22.6%) were diagnosed with psoriasis punctata after evaluation with clinical photographs and lesion descriptions (see Figure 1). The remaining 72 patients were categorised as the ‘other subtype’ group. Psoriasis punctata group had a younger average age at diagnosis (31.0 years) than the other subtypes (37.5 years). Sex proportions and the percentage of patients with pre-existing psoriasis were similar in both groups. Adalimumab and infliximab were most associated with psoriasis punctata (40.9% each), whereas adalimumab was most associated with other subtype psoriasis (56.9%). Average onset of psoriasis after starting TNF-alpha inhibitors was shorter in the psoriasis punctata group (19.0 months), than in the other subtype group (27.1 months), although this difference was statistically insignificant. Crohn's disease was the most common underlying condition in both groups (59.1% and 48.0%, respectively). Psoriasis distribution was similar in both groups, though psoriasis punctata lesions were more prevalent on the trunk and upper extremities, and less on the palms and soles (Figure 2). Notably, 66.7% of psoriasis punctata patients also presented with concurrent plaque psoriasis.&lt;/p&gt;&lt;p&gt;Psoriasis punctata lesions are often perifollicular and may show clinical and histologic overlap with pustular variants of psoriasis. Distinctive characteristics of psoriasis punctata include a scattered pinpoint rash that may present with an overlying scale. These lesions can occur on any part of the body and are typically smaller than those seen in guttate psoriasis. Previous literature has described various types of psoriasis [&lt;span&gt;4&lt;/span&gt;], with only one case report describing a patient with a ‘follicular psoriasiform eruption’ [&lt;span&gt;2&lt;/span&gt;]. Laga et al. [&lt;span&gt;5&lt;/span&gt;] examined 16 biopsies from nine patients with psoriasiform eruptions on TNF-α inhibitors, revealing psoriasiform patterns, lichenoid/interface patterns and ne","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 1","pages":"42-44"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062878","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":"Ichthyosis Prematurity Syndrome","authors":"Grace X. Li,&nbsp;Kathryn Chen,&nbsp;Deshan F. Sebaratnam,&nbsp;James P. Pham","doi":"10.1111/ajd.14419","DOIUrl":"10.1111/ajd.14419","url":null,"abstract":"&lt;p&gt;Ichthyosis prematurity syndrome (IPS) is a rare autosomal recessive congenital disorder characterised by premature birth, congenital ichthyosis and neonatal respiratory distress. IPS is caused by pathogenic variants of the &lt;i&gt;SLC27A4&lt;/i&gt; gene encoding fatty acid transporter protein 4 (FATP4), resulting in skin barrier dysfunction [&lt;span&gt;1&lt;/span&gt;]. Herein, we present, to our knowledge, the first Australian case of IPS in a patient of Indonesian heritage.&lt;/p&gt;&lt;p&gt;A male infant of Indonesian heritage was born at 29 + 3 weeks gestation with diffuse scaling. He was born to healthy non-consanguineous parents, with his mother gravida 1, parity 1. Routine antenatal screening was unremarkable, but polyhydramnios was identified 1 day prior to delivery. Labour was induced following prolonged rupture of membranes with suspected chorioamnionitis, and he was ultimately born via Caesarean section due to breech positioning and foetal distress.&lt;/p&gt;&lt;p&gt;His birthweight was 1882 g, and his APGAR scores at 1, 5 and 10 minutes were 1, 6 and 6, respectively. Widespread clay-like vernix was noted affecting the scalp, face, back and upper and lower extremities (Figure 1), with occlusion of the auditory canals. Soon after birth, he developed respiratory distress, with chest X-ray showing ill-defined multilobar opacities compatible with pulmonary oedema (Figure 2). He had transient eosinophilia of 12% (normal: &lt; 5%). Serum immunoglobulin E (IgE) was not tested. No abnormal findings were reported on abdominal X-ray, renal ultrasound and cranial ultrasound. Histology of the exfoliated scale demonstrated anucleate keratin.&lt;/p&gt;&lt;p&gt;He was transferred to the neonatal intensive care unit, placed on continuous positive airway pressure (CPAP) ventilation and administered surfactant. CPAP was transitioned to low-flow oxygen on day 19 postnatally. Other postnatal complications included jaundice, &lt;i&gt;Staphylococcus aureus&lt;/i&gt;-associated conjunctivitis and anaemia of prematurity. Breastfeeding was supplemented by enteral nutrition.&lt;/p&gt;&lt;p&gt;The patient was discharged after 10 weeks (corrected age 39 + 4 weeks gestation), with a continuing requirement for low-flow oxygen until 5 months of age. Newborn hearing screen test results were abnormal but normalised at 4 months. His skin was managed with white soft paraffin, with spontaneous shedding of scale. At 8 months, there was complete resolution of ichthyosis (Figure 2), and development was within normal limits.&lt;/p&gt;&lt;p&gt;Genetic testing confirmed the presence of germline, compound heterozygous variants of the &lt;i&gt;SLC27A4&lt;/i&gt; gene. The first was a pathogenic deletion of exons 8 to 10, previously implicated in IPS [&lt;span&gt;2, 3&lt;/span&gt;]. The second was a single nucleotide change at c.986C&gt;T (p.Thr329Met) of uncertain significance, which has been previously reported in the literature as a homozygous variant in patients with clinical IPS [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;While respiratory distress may also be seen in collodion and Harlequin presentations, in","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 2","pages":"107-109"},"PeriodicalIF":2.2,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045471","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":"Wolf's Isotopic Response: Acquired Arteriovenous Haemangioma Following Oral Herpes Simplex Virus Infection","authors":"Vanessa Tran,&nbsp;Vanessa Morgan,&nbsp;Laura Scardamaglia","doi":"10.1111/ajd.14421","DOIUrl":"10.1111/ajd.14421","url":null,"abstract":"<div>\u0000 \u0000 <p>Cutaneous arteriovenous haemangioma (AVH) is a rare benign vascular lesion, which typically occurs on the head and neck. Its aetiology is unclear but thrombosis, trauma, infection or endocrine triggers have been proposed. We report the case of a 64-year-old female presenting with acquired AVH of the upper lip following oral herpes simplex virus infection. This is the first documented occurrence of AVH as a post-herpetic isotopic response (PHIR).</p>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 2","pages":"e46-e48"},"PeriodicalIF":2.2,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045474","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}