Australasian Journal of Dermatology最新文献

{"title":"Real-world effectiveness and safety of tofacitinib for alopecia areata: A retrospective cohort study of 202 patients","authors":"William Cranwell MBBS(Hons), BMedSc(Hons), MPH&TM, FACD,&nbsp;Nekma Meah MBChB, MRCP (UK), MRCP(Derm), FACD,&nbsp;Dmitri Wall MRCP(Derm),&nbsp;Bevin Bhoyrul MBBS, MRCP (UK), FACD,&nbsp;Bokhari Laita MPhil, MMed,&nbsp;Rodney D. Sinclair MBBS, MD, FACD","doi":"10.1111/ajd.14325","DOIUrl":"10.1111/ajd.14325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alopecia areata (AA) is an autoimmune hair loss disorder characterised by collapse of hair follicle immune privilege and mediated by autoreactive CD8+ T lymphocytes and natural killer cells. Treatment is often unsatisfactory. The Janus kinase-signal transducer and activator of transcription (JAK–STAT) pathway is implicated in the pathogenesis of AA and Janus Kinase inhibitor (JAKi) medications are promising emerging treatments for AA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We evaluated the safety and effectiveness of tofacitinib in a real-world setting over 18 months of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of all patients with scalp AA commenced on tofacitinib between 1 November 2016 and 31 May 2019. The primary endpoint was the percent change in Severity of Alopecia Tool (SALT) score at 18 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and two patients were included. After 18 months of treatment, 55.9%, 42.6% and 29.2% achieved 50%, 75% and 90% reductions in their SALT scores respectively. Increased duration of AA was a negative predictor of hair regrowth. Males and patients with baseline SALT ≥90 were slower to respond to treatment in the first 12 months. One hundred and twenty-four patients and 168 patients received concomitant systemic corticosteroids or low-dose oral minoxidil during tofacitinib therapy respectively. There were no serious adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tofacitinib was a safe and effective treatment for patients with moderate-to-severe AA. Further randomised controlled studies are needed to establish the optimal treatment regimen.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 6","pages":"505-513"},"PeriodicalIF":2.2,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236865","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":"Dermatoscopy of pigmentary changes in systemic sclerosis","authors":"Sushama Sushama MD,&nbsp;Shivani Bansal MD, DNB, MNAMS,&nbsp;Kavita Poonia MD, DNB, MNAMS","doi":"10.1111/ajd.14328","DOIUrl":"10.1111/ajd.14328","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 6","pages":"e171-e175"},"PeriodicalIF":2.2,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141173715","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":"Tildrakizumab use for recalcitrant pityriasis rubra pilaris","authors":"Zachary Holmes MBBChBAO, MSc, MRCP,&nbsp;Michelle S. Goh MBBS, FACD,&nbsp;Peter Foley MD, FACD,&nbsp;Benjamin S. Daniel MBBS, MMed, FACD","doi":"10.1111/ajd.14307","DOIUrl":"10.1111/ajd.14307","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"476-479"},"PeriodicalIF":2.2,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141173720","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":"Identifying dermatological emergencies in patients with skin of colour: Insights from Australian emergency medicine practitioners","authors":"N. Punchihewa MD,&nbsp;P. Pouryahya MD, FACEM, GC ClinEpi, CCPU, M Traumatology, MPH,&nbsp;M. Rodrigues MBBS (Hons), FACD","doi":"10.1111/ajd.14324","DOIUrl":"10.1111/ajd.14324","url":null,"abstract":"&lt;p&gt;Many dermatological conditions can be managed in an outpatient setting; however, some are life-threatening emergencies requiring prompt diagnosis and management. Textbook images of dermatological conditions primarily showcase manifestations on light skin, leading to a significant underrepresentation of patients with skin of colour (SOC).&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Previous research has revealed that common skin conditions may possess distinct variations in patients with SOC&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; yet this remains largely unexplored within the realm of dermatological emergencies. Given doctors in the emergency department are likely to encounter such presentations before dermatologist consultation, providing comprehensive education in this domain is crucial. The objective of this study is to evaluate and address the knowledge gaps and preferences for further education initiatives among emergency medicine practitioners in diagnosing dermatological emergencies in patients with SOC, with the overarching goal of enhancing patient care across diverse populations.&lt;/p&gt;&lt;p&gt;An online survey and quiz were distributed among emergency medicine practitioners in Victoria, Australia from February to October 2023. The survey gathered information regarding participant demographics, confidence in diagnosing dermatological emergencies in individuals with SOC and attitudes towards current training formats. The quiz comprised clinical images of dermatological emergencies in four separate patients with SOC, accompanied by multiple-choice questions. A total of 76 doctors participated in the survey, including 17 junior doctors (22%), 18 registrars (24%) and 41 consultants (54%).&lt;/p&gt;&lt;p&gt;Our quiz findings indicate variations in response accuracy across different questions, highlighting existing uncertainty among emergency medicine practitioners in diagnosing dermatological emergencies specific to SOC. Question 1 showed an image of lower limb cellulitis in an adult with Fitzpatrick skin type (FST) 6 for which 36% of respondents selected the correct answer. Background pigmentation masking erythema in darker skin tones may have contributed to the low amount of correct responses.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Question 2 showed an image of eczema herpeticum in a child with FST 3 for which 78% of respondents selected the correct answer. The appearance of monomorphic vesicles and punched-out erosions in this condition is less influenced by alterations in the background skin pigmentation, potentially contributing to the observed high rate of accurate responses.&lt;/p&gt;&lt;p&gt;Question 3 showed an image of psoriatic erythroderma in an adult with FST 6 for which 45% of respondents selected the correct answer. Psoriatic plaques in SOC have a violaceous hue compared with salmon-pink plaques observed in light skin&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; which may have caused difficulty identifying the correct answer. Question 4 showed an image of toxic epidermal necrolysis (TEN) in an adult with FST 5 for wh","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 6","pages":"524-534"},"PeriodicalIF":2.2,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141173718","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":"Ineffectiveness of apremilast in moderate-to-severe pemphigus: A case series of three patients","authors":"Quanhong Zhang MM,&nbsp;Lang Yu MM,&nbsp;Li Wan MM,&nbsp;Liuqing Chen MD,&nbsp;Jinbo Chen MD, PhD","doi":"10.1111/ajd.14312","DOIUrl":"10.1111/ajd.14312","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"e121-e122"},"PeriodicalIF":2.2,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086423","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":"Delineating the bidirectional association between pyoderma gangrenosum and immune-mediated rheumatic diseases: A population-based study","authors":"Khalaf Kridin PhD,&nbsp;Adi Klein Bitterman MD,&nbsp;Helana Jeries MD,&nbsp;Fadi Hassan MD,&nbsp;Mohammad E. Naffaa MSc,&nbsp;Arnon D. Cohen PhD","doi":"10.1111/ajd.14310","DOIUrl":"10.1111/ajd.14310","url":null,"abstract":"&lt;p&gt;Pyoderma gangrenosum (PG) is a rare chronic ulcerating skin disorder with an immunological pathomemchanistic basis.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; As with other neutrophilic dermatoses, PG usually has an associated disorder,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; mainly Inflammatory bowel disease, arthritis and haematological malignancies.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Immune-mediated rheumatic diseases (IMRD) are defined as a group of acquired diseases resulting from persistent immune-mediated inflammation.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; These autoantibodies or autoreactive T cells can attack any organ of the body, leading to a wide array of signs and symptoms.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; This disease group consists of several potentially devastating conditions such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc), rheumatoid arthritis (RA), psoriatic arthritis (PsA),&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Sjögren syndrome and dermatomyositis.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Several case reports have pointed to the coexistence of PG and IMRD in individual patients.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; While the association of PG with RA is robust,&lt;span&gt;&lt;sup&gt;3, 7&lt;/sup&gt;&lt;/span&gt; our knowledge about the potential of SLE, SSc and PsA to trigger PG is very sparse. The current study sought to investigate the bidirectional association between PG and IMRD. To outline the risk of developing IMRD after PG, we adopted a retrospective cohort study design, in which patients with PG were followed over time to estimate the incidence of IMRD. Additionally, to examine the likelihood of developing PG in individuals with a history of IMRD, we employed a case–control study design exploring the prevalence of preexisting IMRD (as the exposure) among patients who subsequently developed PG (as the outcome).&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; The Appendix S1 further details information about the study population and the statistical analyses utilized in the current study.&lt;/p&gt;&lt;p&gt;The current study consisted of 302 with PG and 1497 matched control individuals. Characteristics of the study population are delineated in Table 1. A case–control study was conducted to clarify whether a history of IMRD places patients at increased odds of developing PG (Table 2). The likelihood of developing PG after being diagnosed with IMRD was increased more than threefold (OR: 3.89; 95% CI: 2.16–7.05). In a granular analysis, the odds of PG were elevated following SLE, SSc and RA, but not PsA (Table 2). In a multivariate analysis, a history of IMRD independently conferred more than fourfold elevated odds of PG (adjusted OR: 4.28; 95% CI: 2.21–8.32; &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;&lt;p&gt;A retrospective cohort study followed patients with PG and controls longitudinally and estimated the incidence of new-onset IMRD (Table 3). Overall, four cases of new-onset IMRD occurred among patients with PG and seven cases among controls. The crude risk of developing IMRD was comparable between cases and controls (HR: 3.19; 95% CI: 0.93–10.90; &lt;i&gt;p&lt;/i&gt; = 0.064). The","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"480-483"},"PeriodicalIF":2.2,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086412","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":"Cross-sectional burden-of-illness study in atopic dermatitis (MEASURE-AD) in Australia and New Zealand reveals impacts on well-being","authors":"Marius Rademaker FRCP (Edin) FACD DM,&nbsp;Paul Jarrett FRACP FRCP (Edin),&nbsp;Dedee F. Murrell FACD MD,&nbsp;Rodney D. Sinclair FACD MD,&nbsp;Lauren Pasfield,&nbsp;David Poppelwell,&nbsp;Stephen Shumack FACD","doi":"10.1111/ajd.14308","DOIUrl":"10.1111/ajd.14308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To describe disease burden in individuals with moderate-to-severe atopic dermatitis (AD) in Australia and New Zealand (ANZ) and compare it with other geographic regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicentre, cross-sectional, observational study (MEASURE-AD) recruited consecutive adolescent and adult patients attending dermatology clinics in 28 countries. Data collected included scores of pruritus, disease severity, sleep, pain, disease control, work and quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 112 ANZ participants (Australia <i>n</i> = 72; New Zealand <i>n</i> = 40) from December 2019 to December 2020. Treatments included topicals (85.7% of patients), non-biologic systemic therapy (28.6%), phototherapy (9.8%) and dupilumab (4.5%). Mean Eczema Area and Severity Index (EASI) score was 22.3 (95% CI 19.6–25.0) and Patient-Oriented Eczema Measurement (POEM) score was 18.4 (95% CI 16.8–20.0). Pruritus Numerical Rating Scale (NRS) was 6.0 (95% CI 5.5–6.6) (50% had severe pruritus) and Dermatology Life Quality Index (DLQI) 14.3 (95% CI 12.8–15.8). ADerm-Impact sleep domain score was 15.1 (95% CI 13.2–16.9). ADerm-Symptom Scale worst skin pain domain score was 5.0 (95% CI 4.3–5.6). Work Productivity and Activity Impairment (WPAI) percentages indicated work and productivity impairment. Inadequately controlled AD was self-reported by 41%, with 9.7 flares in the past 6 months. Scores of pruritus, disease severity, sleep, pain, disease control and quality of life in ANZ were often the highest of all the geographic regions studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ANZ patients with AD have a high disease burden, which extends across multiple facets of daily life. Many are inadequately controlled with existing therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 6","pages":"e145-e155"},"PeriodicalIF":2.2,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074395","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":"Health-related quality of life of adult and adolescent patients living with alopecia areata in Australia","authors":"Rodney Sinclair MBBS, MD, FACD,&nbsp;Samantha Eisman MBChB, MRCP, FACD,&nbsp;Carol M. Y. Lee BSc (Hons), PhD,&nbsp;Maureen Hitschfeld BSc, MPH,&nbsp;David Witcombe BAppSc, PhD,&nbsp;Candida da Fonseca Pereira PhD, MBA","doi":"10.1111/ajd.14311","DOIUrl":"10.1111/ajd.14311","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To understand the experiences of adolescent and adult patients living with alopecia areata (AA) in Australia regarding symptom severity and the impact on psychosocial well-being and work/classroom productivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A cross-sectional online patient survey among adolescent and adult patients diagnosed with AA was recruited via the Australia Alopecia Areata Foundation. Patient-reported outcomes were also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 337 patients (49 adolescents; 288 adults), with a mean ± standard deviation age of 14.7 ± 1.55 and 38.9 ± 13.31 years for adolescents and adults, respectively, were included. In the group with extensive hair loss (Scalp Hair Assessment Patient-Reported Outcome, categories 3 + 4, <i>n</i> = 172), we observed higher emotional symptom and activity limitation scores (Alopecia Areata Patient Priority Outcomes, emotional symptoms: adults 2.5 ± 1.03, adolescents 2.2 ± 1.15; activity limitations: adults 1.4 ± 1.15, adolescents 1.2 ± 0.99). Additionally, in adults, the Alopecia Areata Symptom Impact Scale global score was 4.0 ± 2.10 (symptoms subscale score 4.1 ± 1.91; interference subscale scores 3.8 ± 2.73). Hospital Anxiety and Depression Scale scores were high across participants, irrespective of hair loss extent (adults: anxiety 9.2 ± 3.85, depression 6.6 ± 3.95; adolescents: anxiety 9.7 ± 4.65, depression 5.2 ± 3.59). Work and classroom productivity were substantially impaired due to AA, with 70.5% of adults and 57.1% of adolescents reporting activity impairment, and overall work/classroom impairment reported at 39.2% and 44.9%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AA impacts the physical, emotional and psychosocial well-being of both adult and adolescent patients. More extensive hair loss more profoundly impacts those living with AA. Patients may benefit from patient-centred care approaches addressing the impact of hair loss on mental and emotional well-being, daily activities and work productivity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 5","pages":"451-461"},"PeriodicalIF":2.2,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065327","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":"Rejuvenation of the dorsal hand by injectable poly-D, L-lactic acid: A pilot study","authors":"Sheng-Hsiang Ma MD,&nbsp;Chuan-Yuan Lin MD,&nbsp;Jui-Yu Lin MD,&nbsp;Yun-Ting Chang PhD,&nbsp;Chih-Chiang Chen PhD","doi":"10.1111/ajd.14302","DOIUrl":"10.1111/ajd.14302","url":null,"abstract":"&lt;p&gt;The dorsal hands are subject to photodamage and may present with increased wrinkling and soft tissue atrophy during the aging process. In recent years, dorsal hand rejuvenation has gained popularity in cosmetic dermatology. Several treatment modalities, including laser resurfacing, fat grafting, and dermal fillers, have been widely used.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Hyaluronic acid-based dermal fillers have been most commonly utilized for dorsal hand rejuvenation in the literature; however, some studies have used collagen stimulators, such as poly L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Injectable poly-D, L-lactic acid (PDLLA), another collagen-stimulating dermal filler, is commonly used for facial contouring and volumization.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; However, its use in dorsal hand rejuvenation has not been reported. Thus, this pilot study aimed to evaluate the efficacy of injectable PDLLA in reducing the visibility of veins and tendons and diminishing wrinkling on the dorsal hand. Besides, the safety profile of PDLLA was also analysed.&lt;/p&gt;&lt;p&gt;The inclusion criteria for this study were healthy adult participants who wished to improve their dorsal hand appearance. Five participants were included in the study. Injectable PDLLA (AestheFill; REGEN) was used for dorsal hand rejuvenation. A total of 6 mL of sterile water was used for the reconstitution of a vial of injectable PDLLA, and 1 mL of 2% lidocaine was added to decrease the discomfort associated with injection. Each side of the dorsal hand was injected with 1 vial of PDLLA. During injection, the patient was placed supine on an operating table. A 23G cannula was used for PDLLA injection, and two injection entry points were chosen, including the interdigital space between the index and middle fingers and the space between the fourth and little fingers (Figure 1). PDLLA was injected just beneath the dermis layer and retrograde injection with distal-proximal fanning and cross-hatched techniques were used to ensure an even injection. After PDLLA injection, the area was gently massaged for 5–10 s. Ice packing after injection is suggested, for 10 min each time, several times a day within the first 3 days.&lt;/p&gt;&lt;p&gt;After injection, the veins and tendons on the dorsal hands became less evident, along with an improvement in wrinkling (Figure 2). The improvement in appearance was maintained up to 1-year post-injection, with a gradual decrease in efficacy afterward. Patient report outcomes, including attractiveness, a more youthful appearance, decreased visibility of veins and tendons, and satisfaction with the treatment results, were collected. The results showed that all participants had high level of satisfaction. Two participants experienced localized erythema, pain, and edema after the injection, which were mild and subsided gradually within 1 week. None of the patients experienced major complications, including infection, hematoma, allergy, or vascular occlusion","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 6","pages":"e168-e170"},"PeriodicalIF":2.2,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065329","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":"Kava-induced dermatitis: A detailed histopathological analysis","authors":"Jacqueline du Plessis Nisbet MD, MMed,&nbsp;Danica Xie MD, MMed,&nbsp;Russell Thompson MD,&nbsp;Kirsty Wark MD, MMed,&nbsp;Edwina Lamrock FACD,&nbsp;James Scurry FRCPA","doi":"10.1111/ajd.14305","DOIUrl":"10.1111/ajd.14305","url":null,"abstract":"<p>Kava induced dermatitis has been reported in previous case series, however the histology has rarely been described. This case report details an erythematous eruption associated with Kava ingestion and the associated folliculocentric sebaceous inflammation found on histological analysis.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 6","pages":"520-523"},"PeriodicalIF":2.2,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065328","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}