Australasian Journal of Dermatology最新文献

{"title":"The Utility of the SUNTRAC Tool in Predicting Skin Cancers in Renal Transplant Patients.","authors":"Sarah Seol, Samuel Reddish, Amanda Oakley","doi":"10.1111/ajd.14558","DOIUrl":"10.1111/ajd.14558","url":null,"abstract":"<p><p>This study evaluates the SUNTRAC tool in guiding initial skin cancer risk stratification among renal transplant patients in New Zealand. Higher retrospectively applied SUNTRAC grades in 219 patients were associated with higher incidence of skin cancer, supporting the tool's effectiveness in guiding initial skin cancer risk stratification in this population.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526234","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":"Management Strategies for Generalised Granuloma Annulare: A Systematic Review of Current and Emerging Therapies","authors":"Luca Bettolini,&nbsp;Vincenzo Maione,&nbsp;Andrea Carugno,&nbsp;Giorgio Stabile,&nbsp;Antonio Podo Brunetti,&nbsp;Zeno Fratton,&nbsp;Enzo Errichetti,&nbsp;Nicola Zerbinati,&nbsp;Franco Rongioletti,&nbsp;Piergiacomo Calzavara-Pinton,&nbsp;Mariateresa Rossi,&nbsp;Stefano Bighetti","doi":"10.1111/ajd.14560","DOIUrl":"10.1111/ajd.14560","url":null,"abstract":"<p>Generalised Granuloma Annulare (GGA) is a chronic inflammatory skin disorder with no standard treatment. Since the last review in 2013, new treatments and varied responses have highlighted the need for an updated synthesis to guide clinical decisions. This systematic review aimed to evaluate the epidemiology, comorbidities and treatment outcomes in patients with GGA, synthesising evidence from published studies to provide insights into both conventional and emerging therapeutic strategies. A systematic literature search was conducted in CENTRAL, Embase and PubMed, following PRISMA guidelines. Studies published in English, French or Spanish up to January 15, 2024, were included. Data extraction focused on patient demographics, comorbidities, treatment regimens and therapeutic outcomes. A total of 689 patients were included. The mean age of patients was 52.8 years, with a female predominance (72.6%). Based on this systematic review, we propose a stepwise approach: first-line treatment includes hydroxychloroquine and phototherapy (PUVA &gt; UVA1 &gt; nb-UVB). Oral corticosteroids along with high-potency topical steroids or calcineurin inhibitors may be used in extensive or rapidly progressive disease or as bridging therapy pending slower-acting agents. Sulfones are second-line, with oral retinoids (e.g., isotretinoin) as alternatives if contraindicated. For refractory cases, off-label anti-TNF-α agents or JAK inhibitors are recommended, with methotrexate or cyclosporine as valid alternatives. This largest systematic review of GGA treatments offers an evidence-based clinical framework. While steroids and phototherapy remain standard, emerging options like JAK inhibitors and biologics show promise for refractory cases. Tailored, multimodal strategies may improve outcomes, though further trials are needed to standardise guidelines.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"329-337"},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526233","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":"Real World Side-Effects of Dupilumab: A Narrative Review","authors":"Conor Larney,&nbsp;Peter Foley,&nbsp;Jason Wu,&nbsp;Benjamin S. Daniel","doi":"10.1111/ajd.14557","DOIUrl":"10.1111/ajd.14557","url":null,"abstract":"<div>\u0000 \u0000 <p>Real-world use of dupilumab has unveiled a spectrum of side effects that were not fully appreciated in initial clinical trials. While dupilumab remains a highly effective treatment for atopic dermatitis, clinicians must be aware of real-world adverse effects including ocular complications, inflammatory arthritis, psoriasiform eruptions and head and neck dermatitis; as well as reported associations including cutaneous T-cell lymphoma, alopecia areata, vitiligo and weight gain.</p>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"e324-e334"},"PeriodicalIF":1.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482928","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 Systematic Review of Cellulitis Guidelines: The Role of Non-Pharmacological Management in Preventing Recurrence","authors":"Janette Jacka,&nbsp;Robyn Sierla,&nbsp;Sharon L. Kilbreath,&nbsp;Elizabeth S. Dylke","doi":"10.1111/ajd.14546","DOIUrl":"10.1111/ajd.14546","url":null,"abstract":"<p>Cellulitis is a common acute skin and soft tissue infection with high rates of recurrence. Historically, guidelines for care have focused on pharmacological management; however, emerging evidence supports the benefits of non-pharmacological approaches for risk mitigation and recurrence prevention. This review examined best practice guidelines for the management of cellulitis—for the inclusion of recommendations beyond antibiotics to prevent recurrence. A systematic search of seven databases was conducted, including the Guidelines International Network (GIN), the Agency for Healthcare Research and Quality and the Australian National Health and Medical Research Council clinical practice guidelines. Guidelines were included if they addressed lower limb cellulitis, were developed after 2000, published in English, appeared in a peer-reviewed journal and/or were endorsed by a health agency or government body, and contained recommendations for non-pharmacological management. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was used to assess guideline quality. Ten guidelines met the inclusion criteria. Recommendations for non-pharmacological management and recurrence prevention primarily addressed risk factors such as venous disease, oedema, tinea, skin barrier integrity and obesity. However, these recommendations were often brief and lacked actionable strategies for managing local risk factors effectively. Most guidelines scored poorly in the AGREE II assessment, particularly in rigour of development, despite performing well in scope, purpose and clarity. Furthermore, non-pharmacological strategies and recurrence prevention remain underdeveloped. Strengthening the evidence base and incorporating targeted prevention strategies will be essential to improving future guidelines, ultimately enhancing patient outcomes and reducing the burden on healthcare systems.</p><p><b>Trial Registration:</b> Registered with Open Science Framework OSF: osf-registrations-7wkvf-v1</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"321-328"},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14546","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324330","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":"Spotted Fever After Safari and the Value of an Eschar Swab","authors":"Aoife Boyle,&nbsp;Catherine Uhomoibhi,&nbsp;Siân Tiley,&nbsp;Aoife Cotter,&nbsp;Fergal J. Moloney","doi":"10.1111/ajd.14551","DOIUrl":"10.1111/ajd.14551","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"e369-e370"},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301112","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":"Bilateral Palmar Rash With Azathioprine Rechallenge","authors":"Zoe Lee,&nbsp;Catriona Brennan,&nbsp;Gillian Marshman","doi":"10.1111/ajd.14550","DOIUrl":"10.1111/ajd.14550","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"369-370"},"PeriodicalIF":1.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282302","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":"Pigmented Rings With Central Clearing: A Dermoscopic Feature of Melasma.","authors":"Nisal Punchihewa, Bianca Sanabria, Tasneem F Mohammad, Senhong Lee, Babar Rao, Michelle Rodrigues","doi":"10.1111/ajd.14549","DOIUrl":"10.1111/ajd.14549","url":null,"abstract":"<p><p>Melasma, a challenging pigmentary disorder affecting the face, often poses diagnostic difficulties due to its similarity to numerous other conditions. This study aimed to introduce and evaluate a novel dermoscopic feature, pigmented rings with central clearing (PRCC), in aiding the diagnosis of melasma and distinguishing it from similar conditions.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282303","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":"Psychosocial Determinants and Atopic Dermatitis Outcomes: A Cross-Sectional Study From an Australian Paediatric Centre","authors":"Ashling Courtney,&nbsp;Anousha Yazdabadi,&nbsp;Emily Schembri,&nbsp;Adrian J. Lowe,&nbsp;Crystal Williams,&nbsp;John C. Su","doi":"10.1111/ajd.14547","DOIUrl":"10.1111/ajd.14547","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atopic dermatitis (AD) significantly impacts quality of life, with well-documented physical and psychological consequences. While disease burden is well characterised, the influence of psychosocial determinants on AD outcomes remains underexplored. This study examines these factors in an Australian paediatric population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate whether children from populations at risk of health inequities—such as those from rural areas, culturally diverse backgrounds, First Nations communities, socioeconomically disadvantaged postcodes, those with neuropsychiatric conditions and ‘Vulnerable’ children (defined as those under state or relative care or with a history of familial abuse or neglect)—experience more severe disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study included children ≤ 16 years with confirmed AD attending a tertiary paediatric referral centre in Melbourne (Aug 2022—Aug 2023). Risk factors were defined by social determinants of health, including economic, cultural and geographic influences. Disease outcomes (severity, hospitalisations, emergency department visits treatment patterns) were analysed using univariate and multivariate methods. A total of 454 at-risk children were compared to 454 controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children from at-risk groups were more likely to have severe AD (43.8% vs. 28.3%, <i>p</i> &lt; 0.001), higher annual rates of hospital admissions, increased antibiotic use, and greater prednisolone use for flares (<i>p</i> &lt; 0.001). Multivariate analysis revealed significantly higher odds of severe AD (aMOR 4.72, <i>p</i> &lt; 0.001) and hospitalisation (aIRR 2.73, <i>p</i> &lt; 0.001) in the at-risk cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Psychosocial determinants of health are associated with increased AD severity and healthcare use in children. These findings highlight the need for targeted, equity-focused interventions to reduce disparities in AD care in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"e346-e354"},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14547","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274124","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":"Eight-Year Experience of Hedgehog Pathway Inhibitors at Three Tertiary Referral Centres in the Australian State of Victoria.","authors":"Christian Gan, Nicholas Manuelpillai, Peter Foley, Christopher McCormack, Michelle S Goh","doi":"10.1111/ajd.14544","DOIUrl":"10.1111/ajd.14544","url":null,"abstract":"<p><p>This retrospective analysis of Hedgehog inhibitor treatment in 32 patients with Gorlin syndrome, locally advanced and metastatic basal cell carcinoma (BCC) at three tertiary referral centres in Victoria, Australia from April 2017 until 30 June 2024 demonstrated an 84% overall objective response rate (partial and complete response combined). However, 90% of patients experienced adverse effects impacting quality of life. Secondary acquired drug resistance occurred in 77% (10/13) of locally advanced and metastatic BCC patients after a median duration of 13 months. Further work is needed to optimise the neoadjuvant use of Hedgehog inhibitors with radiotherapy or surgery given poor long-term Hedgehog inhibitor tolerability and to develop strategies to counteract the issue of acquired resistance.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257217","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":"A Retrospective Observational Study of the Incidence and Associated Risk Factors of Skin Cancers in Renal Transplant Recipients in Canterbury, New Zealand","authors":"Julia (Xiaoyu) Zhu,&nbsp;Eve Mallon,&nbsp;Caroline Mahon,&nbsp;Nicholas Cross,&nbsp;Amanda Oakley","doi":"10.1111/ajd.14538","DOIUrl":"10.1111/ajd.14538","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Skin cancer is a significant complication amongst renal transplant recipients, associated with substantial morbidity and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This retrospective observational study aimed to assess the incidence and identify associated risk factors for skin cancers amongst renal transplant recipients in Canterbury, New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed data from 177 renal transplant recipients who underwent transplantation between January 2004 and December 2015.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Amongst the patients, 32% developed skin cancers. The mean age of the study cohort is 57 years with a mean age at transplant of 47 years. A total of 315 histologically proven invasive skin cancers were recorded, with a squamous cell carcinoma (SCC) to basal cell carcinoma (BCC) ratio of 1.25:1. Forty-four patients had died by the study's conclusion, with metastatic skin cancer accounting for four deaths (9%). Non-melanoma skin cancers (NMSC) showed significant associations with older age and older age at transplant (<i>p</i> &lt; 0.001). Male gender, skin phototype I-III, and ciclosporin exposure were also associated with increased NMSC risk (<i>p</i> &lt; 0.05). The cumulative 10-year risk for NMSC amongst renal transplant recipients was estimated at 28.85% (95% CI = 28.77–28.91).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study confirms a high incidence of skin cancers amongst renal transplant recipients in Canterbury, New Zealand, consistent with international findings. Understanding the risk factors for skin cancer can aid in developing targeted strategies for prevention and management in transplant recipients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"66 6","pages":"350-358"},"PeriodicalIF":1.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257216","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}