British Journal of Dermatology最新文献

{"title":"Artificial daylight photodynamic therapy using methyl aminolaevulinate in a real-world setting in Germany: results from the noninterventional study ArtLight.","authors":"Wolfgang G Philipp-Dormston, Matthias Brückner, Matthias Hoffmann, Melvin Baé, Jörg Fränken, Bernd Großmann, Uwe Paasch, Sven Quist, Berenice M Lang, Rajeev Chavda, Rolf-Markus Szeimies","doi":"10.1093/bjd/ljae437","DOIUrl":"10.1093/bjd/ljae437","url":null,"abstract":"<p><strong>Background: </strong>Artificial daylight photodynamic therapy (ADL-PDT) is an alternative, all-year applicable, nearly painless treatment approach for actinic keratosis (AK) with comparable effectiveness to daylight or conventional PDT. At the time this study was initiated, methyl aminolaevulinate (MAL) was the only photosensitizer approved for ADL-PDT in Germany.</p><p><strong>Objectives: </strong>To gain comprehensive insights into the practicability of MAL-ADL-PDT in patients with AK using different artificial daylight sources under real-world conditions.</p><p><strong>Methods: </strong>This prospective, noninterventional, multicentre study (ArtLight, NCT05725213) enrolled patients with Olsen grade 1 or 2 AK on the face and scalp in Germany. Patients were treated with MAL-ADL-PDT (160 mg g-1 MAL cream). The primary outcome measure was the practicability of MAL-ADL-PDT assessed as rate of resolved AK lesions in the focus area (10 × 10-cm area within the treatment area). Secondary outcomes included treatment-associated pain (numeric rating scale, NRS), Actinic Keratosis Area and Severity Index (AKASI), total lesion count over time, skin preparation, safety, overall assessment of effectiveness, tolerability, adherence and patient satisfaction.</p><p><strong>Results: </strong>In total, 224 patients [median age 75.0 (range 50-91) years, 85.3% male, 62.5% AK Olsen grade 2, 55.4% treatment-naïve] were included and treated with MAL-ADL-PDT. Three months after treatment, lesion counts were reduced in the focus area by 71% (P < 0.001) indicating practicability of the treatment. Nearly all patients (93.3%) experienced no or mild pain during PDT (NRS score 0-3). Median AKASI decreased from 6.2 at baseline to 3.4 at month 3 (95% confidence interval 2.4-3.0; P < 0.001). The majority of investigators (82.8%) and patients (80.0%) were satisfied with the treatment. No new safety signals were reported.</p><p><strong>Conclusions: </strong>The clinical practicability of MAL-ADL-PDT was demonstrated under real-world conditions by effective lesion reduction and predominantly none-to-mild procedural pain. Thus, MAL-ADL-PDT is a convenient way for healthcare professionals to deliver PDT treatment to patients with AK located on the face and scalp.</p>","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"510-519"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical implications of artificial intelligence in skin cancer diagnostics: use-case analyses.","authors":"Syed F H Shah, Daniel Arecco, Heather Draper, Simona Tiribelli, Eli Harriss, Rubeta N Matin","doi":"10.1093/bjd/ljae434","DOIUrl":"10.1093/bjd/ljae434","url":null,"abstract":"<p><strong>Background: </strong>Skin cancer is the most common cancer worldwide. Early diagnosis is crucial to improving patient survival and morbidity. Artificial intelligence (AI)-assisted smartphone applications (apps) for skin cancer potentially offer accessible, early risk assessment of suspicious skin lesions. However, the integration of novel technologies into dermatology pathways raises ethical concerns. Although ethical principles for AI governance are well known, how these principles should be applied to real-life AI apps readily available for public use is less well understood.</p><p><strong>Objectives: </strong>To conduct an ethical use-case analysis of commercially available skin cancer apps, to better understand the ethical issues arising from their development and use in a real-world context.</p><p><strong>Methods: </strong>Established methods for the ethical analysis of clinical AI applications were applied to two popular skin cancer apps in the UK: SkinVision and Scanoma. Systematic searches of published literature, regulatory documents and websites were conducted to review the evidence regarding app development, effectiveness and use. Screening for inclusion was undertaken by two researchers independently. Ethical concerns were identified with reference to previously described ethical concerns and principles for AI-assisted healthcare.</p><p><strong>Results: </strong>By conceptualizing ethical principles within the use-context of skin cancer apps, we identified specific ethical issues arising throughout the AI lifecycle of both apps. One company provided extensive detail regarding algorithm development and decision-making; this information was insufficiently reported for the other app. Other concerns identified were related to number, quality and consistency of studies assessing algorithm efficacy. Limited efforts to address potential skin tone biases and the exclusion of individuals with darker skin tones as target users by one app risks perpetuating existing inequalities. Inadequate regulatory oversight was identified.</p><p><strong>Conclusions: </strong>Findings from our ethical use-case analysis of two patient-facing AI-assisted skin cancer apps suggest inadequate incorporation of bioethical norms such as justice, responsibility and transparency into the development and deployment of both apps. Improved regulation should increase accountability. Ensuring ethics by design through integration between technology developers, dermatologists, ethicists and the public is urgently needed to prevent the potential benefits of AI-assisted skin cancer apps being overshadowed by potential ethical harms.</p>","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"520-529"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting type 2 inflammation in bullous pemphigoid: dupilumab as a game changer opens new avenues.","authors":"Luca Borradori, Michael Hertl","doi":"10.1093/bjd/ljae465","DOIUrl":"10.1093/bjd/ljae465","url":null,"abstract":"","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"377-378"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary cutaneous Alternaria alstroemeriae infection.","authors":"Ximing Yang, Li Li, Min Zhu","doi":"10.1093/bjd/ljae409","DOIUrl":"10.1093/bjd/ljae409","url":null,"abstract":"","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"558"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultraviolet radiation is not the major cause of melanoma mortality in the UK and sun exposure advice should be revised.","authors":"Richard B Weller, Jiayue Gu","doi":"10.1093/bjd/ljae426","DOIUrl":"10.1093/bjd/ljae426","url":null,"abstract":"","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"548-550"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The perceived quality of life in adult patients with inherited ichthyosis: a qualitative interview study.","authors":"Fauve C A P van Veen, Vanya Rossel, Peter M Steijlen, Albine Moser, Karin Veldman, Michel van Geel, Julia M K Clabbers, Jolien van der Geugten, Antoni H Gostyński","doi":"10.1093/bjd/ljae436","DOIUrl":"10.1093/bjd/ljae436","url":null,"abstract":"","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"553-555"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-rater agreement of lesion counts in hidradenitis suppurativa.","authors":"Bria Midgette, Andrew Strunk, Amit Garg","doi":"10.1093/bjd/ljae379","DOIUrl":"10.1093/bjd/ljae379","url":null,"abstract":"","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"535-537"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibroblast-immune crosstalk under mechanical forces in keloids.","authors":"Junxian Wen, Yingrou Tan, Yong Yao Chun, Timothy T Y Tan, Hong Liang Tey","doi":"10.1093/bjd/ljae449","DOIUrl":"10.1093/bjd/ljae449","url":null,"abstract":"","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"556"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world evaluation of the effectiveness and safety of dupilumab in bullous pemphigoid: an ambispective multicentre case series.","authors":"Nidia Planella-Fontanillas, Xavier Bosch-Amate, Alicia Jiménez Antón, Carlos Moreno-Vílchez, María Gamo Guerrero, María Del Mar Blanes Martínez, María Asunción Ballester Martínez, Patricia Bassas-Freixas, Juan Luis Castaño Fernández, Andrea Estébanez Corrales, Ricardo Suarez Fernández, Sergio Santos Alarcón, Ana Bauzá Alonso, Marina Torrent, Adrian Ballano Ruiz, Cristina Collantes Rodríguez, Agustín España, Eduardo Fonseca Capdevila, Inmaculada Gil Faure, Carlos Pelayo Hernández Fernández, Francisco Javier Melgosa Ramos, Jorge Spertino, Violeta Zaragoza Ninet, Lucia Armillas, Isabel Bielsa, Cristina Carrera, Mireia Esquius Rafat, Jon Fulgencio Barbarin, Javier Fernandez Vela, Miguel Lova Navarro, Clara Martín Callizo, Sara Martín-Sala, Rosa Ojeda, Maria Elisabet Parera Amer, Anna Sánchez Puigdollers, Ramon M Pujol, Sebastian Podlipnik, José Manuel Mascaró, Laia Curto-Barredo","doi":"10.1093/bjd/ljae403","DOIUrl":"10.1093/bjd/ljae403","url":null,"abstract":"<p><strong>Background: </strong>Bullous pemphigoid (BP) affects elderly individuals with multiple comorbidities, making conventional treatments unsuitable.</p><p><strong>Objectives: </strong>Evaluate the effectiveness and safety of dupilumab in the treatment of BP.</p><p><strong>Methods: </strong>A multicentre ambispective cohort study was conducted across 34 hospitals. Patients with BP treated with dupilumab were included. Most of the patients (97.1%) received an initial 600-mg dose followed by 300 mg every 2 weeks. The primary outcome was the proportion of patients achieving complete remission (CR) within 4 weeks, defined as an Investigator's Global Assessment score of 0 or 1. CR at weeks 16, 24 and 52, adverse events (AEs), reductions in Peak Pruritus Numerical Rating Scale (PP-NRS) and systemic glucocorticoid use were also assessed.</p><p><strong>Results: </strong>The study included 103 patients with a median age of 77.3 years; 58.3% were male. CR was achieved by 53.4% within 4 weeks and 95.7% by week 52. The PP-NRS score reduced by 70.0% by week 4 and was completely controlled by week 24. Thirteen patients presented with AEs, most of which were mild. Systemic glucocorticoid use reduced by 82.1% by week 52. Shorter disease duration and exclusive cutaneous involvement predicted better response at 16 weeks. No differences in response rates to dupilumab were observed between drug-associated BP and idiopathic cases. No significant difference in response rates was observed between patients treated with dupilumab in monotherapy and those receiving dupilumab with concomitant treatments.</p><p><strong>Conclusions: </strong>Dupilumab is effective, rapid and safe in managing BP, reducing the need for corticosteroids and other treatments. Early initiation and exclusive skin involvement predict better outcomes.</p>","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"501-509"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trichomycosis axillaris.","authors":"Fangfang Bao, Shufen Wang, Chenchen Chen, Yong Zhang, Jianke Li, Xinzhou Liu, Furen Zhang","doi":"10.1093/bjd/ljae397","DOIUrl":"10.1093/bjd/ljae397","url":null,"abstract":"","PeriodicalId":9238,"journal":{"name":"British Journal of Dermatology","volume":" ","pages":"557"},"PeriodicalIF":11.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}