JEADV clinical practice最新文献

{"title":"Disseminated nummular eczema following nivolumab treatment: Successful management with dupilumab","authors":"Betzabé Quiles Martínez,&nbsp;Judith G. Domínguez Cherit,&nbsp;Ángela Rosales Sotomayor,&nbsp;Jorge Gonzalez Torres,&nbsp;Andrea Malagón Liceaga","doi":"10.1002/jvc2.503","DOIUrl":"10.1002/jvc2.503","url":null,"abstract":"<p>An 80-year-old man, without allergies, developed widespread eczema presenting as coin-shaped plaques with severe itching (Figure 1). Nivolumab was prescribed for clear cell renal carcinoma with sternal metastasis. After completing therapy at 2 years, skin lesions appeared few days later. Initial treatments failed, including topical steroids as betamethasone and clobetasol, doxycycline, cetirizine, and tacrolimus. Biopsy confirmed eczematous dermatitis. The total count of serum eosinophils was 0.66 × 10^3/µL (0−0.5 × 10^3/µL), considering a grade 3 immune-related adverse event. Intense pruritus persisted. Dupilumab, started 8 months after eczema onset and combined with tacrolimus cream for 1 year, resulted in significant improvement with minimal lesions and normal eosinophil counts (Figure 2), after which it was discontinued. Under oncology surveillance, the patient achieved a 58% partial tumor response, with no recurrence of his skin condition.</p><p>Nivolumab can lead to cutaneous immune-related adverse events (cirAEs)<span>¹</span> and 41% are eczematous reactions.<span>²</span> Dupilumab, an IL-4a receptor antagonist, is a novel option for various cirAEs, including eczema resistant to conventional drugs,<span>^{3, 4}</span> with a response rate of 44.1% attributed to reduced Th2-axis activation.<span>²</span></p><p>Elevated eosinophils correlate with the severity of cirAEs.<span>²</span> This case highlights the efficacy of dupilumab in treating nummular eczema as a cirAE, as seen in other conditions such as nivolumab-induced bullous pemphigoid.<span>⁵</span></p><p><b>Betzabé Quiles Martínez</b>: Literature review, manuscript writing and patient follow-up. <b>Judith G. Domínguez Cherit</b>: Final manuscript review and patient follow-up. <b>Ángela Rosales Sotomayor</b>: Literature review and initial patient assessment. <b>Andrea Malagón Liceaga</b>: Literature review and manuscript writing. <b>Jorge Gonzalez Torres</b>: Literature review and manuscript writing.</p><p>The authors declare no conflict of interest.</p><p>All patients in this manuscript have given written informed consent for participation in the study and the use of their deidentified, anonymized, aggregated data and their case details (including photographs) for publication. Ethical Approval: not applicable.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1720-1722"},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of miltefosine in the treatment of cutaneous leishmaniasis in French Guiana","authors":"Charlene Oliveira,&nbsp;Kevin Arrivé,&nbsp;Yannick Andro,&nbsp;Celine Michaud,&nbsp;Kinan Drak Alsibai,&nbsp;Pierre Couppie,&nbsp;Magalie Demar,&nbsp;Romain Blaizot","doi":"10.1002/jvc2.400","DOIUrl":"10.1002/jvc2.400","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nearly half of the cutaneous leishmaniasis (CL) cases in French Guiana occur in remote rainforest areas. The treatment of pentamidine-resistant strains currently requires hospitalisation for intravenous amphotericin, involving significant indirect costs. Miltefosine is currently the only oral drug available but is only used in French Guiana as a third- or fourth-line treatment under a temporary use authorisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective of this study was to evaluate the effectiveness of miltefosine in French Guiana. Secondary objectives were to evaluate its safety and acceptability, and patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was carried out at the Cayenne Hospital and remote health centres in French Guiana. All patients with proven CL and treated with miltefosine between 1 January 2017 and 1 April 2022 were included. Cure was defined as complete re-epithelisation with no new lesions at 90 days. Adherence (all doses taken) and side effects were routinely evaluated at the end of treatment. Patients were retrospectively called back to evaluate the impact of CL on their life quality before treatment and their satisfaction with miltefosine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen patients were included. The main species was <i>Leishmania guyanensis</i> (<i>n</i> = 9; 60%), followed by <i>L. braziliensis</i> (<i>n</i> = 4; 26.7%). Eight patients (53.3%) were cured. Eleven patients (73.3%) presented adverse effects (mainly digestive), with seven of these (46.7%) requiring therapeutic adaptations. Eight patients demonstrated complete adherence; of these, six (75%) were cured, including six cases of <i>L. guyanensis</i>, one case of <i>L. braziliensis</i> and one <i>Leishmania</i> spp. Most patients (88.9%) were satisfied with the treatment and said they preferred oral administration to the parenteral route.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Miltefosine is a valuable treatment option for CL in French Guiana. The side effects can diminish patient adherence, but its oral administration is associated with high patient satisfaction. A regular marketing authorisation would facilitate its prescription and allow for the creation of larger cohorts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 3","pages":"850-856"},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.400","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Itchy vesicles on black skin","authors":"Thomas Akel Oberpaur,&nbsp;Tania M. Capusan,&nbsp;Ana R. Gamero Rodríguez,&nbsp;Iván Rodrigo Díaz,&nbsp;Javier Alcántara González,&nbsp;Marta Ruano Del Salado,&nbsp;Cristian Perna,&nbsp;Carla Rodríguez Naranjo,&nbsp;María Elena Sánchez-Largo Uceda","doi":"10.1002/jvc2.485","DOIUrl":"10.1002/jvc2.485","url":null,"abstract":"<p>A 60-year-old black woman from Ghana, who had been residing in Spain for over 20 years, was referred to our clinic after presenting progressively itchy lesions following a unilateral knee replacement surgery 4 months ago. Her medical background was notable for obesity, osteoarthritis, hypertension and hypothyroidism. The patient noted the onset of her symptoms once the postoperative pain had subsided. At first, pruritus and dark macules around the scars were believed to be normal but then continued to develop scaly, and itchy plaques predominantly on the extensor surfaces of both her lower limbs. These plaques gradually progressed to cover her back and trunk, sparing the face and mucous membranes. Her condition had not improved with empiric topical corticosteroids before our evaluation.</p><p>Upon dermatological examination, she exhibited multiple clear vesicles on erosive, pruritic, lichenified and hyperpigmented plaques (Figure 1). These vesicles were noteworthy for not being fragile or entirely flaccid. Certain blood tests were ordered and an intact vesicle and surrounding skin were excised for microscopic investigation (Figure 2).</p><p>PF is a rare subtype of pemphigus, much less frequently encountered than pemphigus vulgaris (PV). It is uncommon globally, with a higher prevalence in endemic areas like Brazil and Africa, more related to geographic and socioeconomic factors rather than ethnicity, age or gender.<span>¹</span> The literature on PF cases in individuals from Africa is limited, though there is a noted higher incidence in South Africa<span>²</span> and endemic occurrences in the northern African countries and the Kilimanjaro region<span>³</span> (namely Kenya and Tanzania). Our case exemplifies a sporadic (nonendemic) occurrence of PF, with no related geographical, travel or medication history. Even though triggers are not usually identified, this case seems to have been triggered by the surgery, which has been reported in some other publications.</p><p>PF's typical presentation involves painful scaly, erythematous erosions in seborrheic areas, with intact vesicles being a rare find.<span>^{4, 5}</span> Our case diverges from the norm, as the patient has never noted pain regarding this condition, seborrheic areas are spared at every flare-up and vesicles remain intact for several days. The presence of circulating antibodies targeting Dsg-1, a necessary adhesion molecule in the outer layers of cutaneos epidermis but not indispensable in mucosas, along with preservation of Dsg-3, reflect the physiopathology of this disease and the differences with PV.<span>⁵</span> Although we cannot establish why the distribution or the symptoms in our case differs from the classic presentation, we can at least hypothesize that the vesicles are less fragile owing to the more compact corneal layer found in black skin.<span>⁶</span> Interestingly, the notorious postinflammatory hyperpig","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 3","pages":"934-937"},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141674064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genital ulcers in hospitalized patients: How often is genital herpes the culprit?","authors":"S. P. Bermúdez-Rodríguez,&nbsp;A. Malagón-Liceaga,&nbsp;G. Figueroa-Ramos,&nbsp;Y. V. Estrada-Caraveo,&nbsp;M. Gatica-Torres,&nbsp;J. Domínguez-Cherit","doi":"10.1002/jvc2.502","DOIUrl":"10.1002/jvc2.502","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Genital herpes (GH) is the main infectious cause of genital ulcers worldwide. Clinical diagnosis alone may be misleading, especially in immunocompromised patients in whom atypical presentations are common.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the herpetic etiology of genital ulcers in immunocompromised and immunocompetent hospitalized adults, and to identify the most frequent differential diagnoses within each patient group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective transverse study at a third-level center in Mexico City using PCR testing (HSV-1, HSV-2, VZV) in hospitalized patients with genital ulcers to diagnose GH. When negative, biopsy and tissue cultures were taken to establish the final diagnosis. Data from a 2-year period (March 2021 to April 2023), including demographic characteristics, comorbidities, initial clinical suspicion, PCR test results, skin tissue biopsy results, cultures results, and final diagnosis, were collected from May 2023 to June 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 59 hospital patients with genital ulcers underwent PCR testing due to clinical suspicion of GH, of which 39 (66%) were immunocompromised. The diagnosis was confirmed in 32/59 cases (54%), of which 22/32 (69%) were immunocompromised and 10/32 (31%) immunocompetent. In the 17 immunocompromised adults in whom GH was excluded, other viral (34%) or bacterial (23%) infections were the next most frequent etiologies. Meanwhile, among the 10 immunocompetent patients without GH, noninfectious causes, such as incontinence-associated dermatitis (15%) and trauma or pressure ulcers (15%), were the most prevalent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Genital ulcers in hospitalized adults should raise the suspicion of infectious etiologies, particularly of GH. Diagnostic confirmation with tests such as PCR is crucial given the uncertainty of its clinical diagnosis. Once GH diagnosis is excluded, immunocompromised patients should be evaluated for other infectious etiologies, while noninfectious causes should be considered first in immunocompetent patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1529-1536"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ixekizumab trough concentrations in psoriasis: Paving the way towards personalised therapy: A cohort study","authors":"Lisa Schots,&nbsp;Rani Soenen,&nbsp;Debby Thomas,&nbsp;Annelies Stockman,&nbsp;Erwin Dreesen,&nbsp;Anke Eylenbosch,&nbsp;Jo Lambert","doi":"10.1002/jvc2.491","DOIUrl":"10.1002/jvc2.491","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Biologics for psoriasis demonstrate varying clinical outcome in real-world practice, implying potential under- and overexposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In this prospective cohort study we aimed to develop and validate an in-house sandwich-type enzyme-linked immunosorbent assay (ELISA) for ixekizumab (IXE), and to explore whether there is an exposure-response relationship in standard maintenance dose for IXE, and whether patient factors influence IXE exposure and clinical outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, multicentric, cohort study in psoriasis patients treated with IXE according to standard dosing regimen (BIOLOPTIM-IXE). IXE trough concentrations (TCs) in sera collected at multiple timepoints were measured using an in-house immunoassay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using MA-IXE117E12 and MA-IXE100F5-biotin as the capture and detection antibodies, respectively, an ELISA was developed with an exposure-response curve ranging from 10 to 0.16525 ng/mL. One hundred-fifteen steady-state serum samples from 48 patients (17 [35.4%] bio-experienced; median body weight, 81.5 kg) were measured. Optimal responders (Psoriasis Area and Severity Index [PASI] ≤ 2) had significantly higher TCs than suboptimal responders (PASI &gt; 2) (median TCs, 4.4 and 3.0 μg/mL, respectively; <i>p</i> = 0.026). Median cohort IXE TC was 4.1 µg/mL [2.8−6.1]. An optimal steady-state IXE TC of 3.4 µg/mL was identified for clinical outcome defined by absolute PASI. Median TCs and absolute PASI were significantly lower and worse, respectively, in patients ≥ 90 kg (<i>p</i> &lt; 0.001 and <i>p</i> = 0.013, respectively) and in bio-experienced subjects (<i>p</i> &lt; 0.001 and <i>p</i> = 0.029, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identified an IXE exposure-response relationship and an optimal effective steady-state TC of 3.4 µg/mL in real-world psoriasis patients, revealing the potential of therapeutic drug monitoring in optimising IXE use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1499-1508"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of dimethyl fumarate in patients with plaque psoriasis meeting the upgrade criteria required for moderate-to-severe disease classification","authors":"Sascha Gerdes,&nbsp;Philipp Al Ghazal,&nbsp;Sebastian Diemert,&nbsp;Christian Termeer","doi":"10.1002/jvc2.504","DOIUrl":"10.1002/jvc2.504","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Oral dimethyl fumarate (DMF) is indicated in patients with plaque psoriasis requiring systemic treatment, including those meeting the upgrade criteria for moderate-to-severe disease classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate quality of life (QoL), effectiveness, and tolerability of DMF during routine clinical practice in a patient population with plaque psoriasis meeting the upgrade criteria for moderate-to-severe disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>UPSKIL was a prospective, noninterventional observational study conducted in Germany from July 2019 to February 2022. Adult patients with Psoriasis Area and Severity Index (PASI) and body surface area (BSA) values ≤ 10 meeting the upgrade criteria for moderate-to-severe psoriasis were included, if therapy with DMF was indicated. Overall and by upgrade criterion, effectiveness was evaluated by change in PASI, BSA, Dermatology Life Quality Index (DLQI), Physician Global Assessment (PGA) and ItchyQoL from baseline to Weeks 24 and 52.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 180 patients (mean age 43.4 years, 60.3% male) were included in the effectiveness analysis. At baseline, the majority of patients suffered from involvement of visible areas (86.1%), presence of single recalcitrant plaques (83.9%), pruritus leading to scratching (81.1%) and involvement of major parts of the scalp (71.1%). Using last observation carried forward (LOCF), the proportion of patients achieving PASI &lt; 3 increased from 7.9% at baseline to 55.3% at Week 52, and the proportion of patients achieving DLQI ≤ 5 increased from 17.4% to 52.1%. Overall and stratified by upgrade criteria, mean PGA improvement was visible in all subgroups presenting with the respective upgrade criterion as indicated by the increasing proportion of patients achieving a PGA score of 0/1 (clear/almost clear). In total, 104 patients (51.2%) experienced at least one adverse drug reaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, treatment with DMF led to substantial improvement of all upgrade criteria, even when discontinued before Week 52. Safety results were consistent with the known safety profile of DMF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1518-1528"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.504","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of miliaria profunda after excessive sweating during a summer vacation","authors":"Ariana Palacio,&nbsp;Karla Medrano Cebrian,&nbsp;Lin-Kristin Koch,&nbsp;Erhard Bierhoff,&nbsp;Sonja Bonness,&nbsp;Uwe Reinhold","doi":"10.1002/jvc2.456","DOIUrl":"10.1002/jvc2.456","url":null,"abstract":"<p>We present the case of an otherwise healthy 34-year-old man of Asian descent diagnosed with miliaria profunda after a 6-week history of generalised anhidrosis after a trip to Mallorca in the summer.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1602-1605"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous body image in patients with lichen planus: A cross-sectional study","authors":"Dimitra Koumaki,&nbsp;Stamatios Gregoriou,&nbsp;Aikaterini Chatziperrou,&nbsp;Georgios Evangelou,&nbsp;Aikaterini Doxastaki,&nbsp;Konstantinos Krasagakis","doi":"10.1002/jvc2.505","DOIUrl":"10.1002/jvc2.505","url":null,"abstract":"&lt;p&gt;Lichen planus (LP) poses a significant challenge due to its chronic inflammatory nature, profoundly affecting the quality of life (QoL) of those afflicted.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The present study sought to comprehensively evaluate the QoL in patients with LP, utilizing a multidimensional approach to capture the diverse facets of their lived experience. Consecutive patients with LP were recruited from the outpatient clinic of the Dermatology Department at a University Hospital in Greece between January 2021 and January 2024. Inclusion criteria comprised individuals aged 18 years and above, diagnosed with LP by a qualified dermatologist. Patients with comorbidities affecting QoL or those unable to complete the study questionnaires were excluded. Demographic and clinical data were collected from eligible participants, including age, gender, duration of LP, and disease severity based on the physician's global assessment of disease (PGA). The patient's disease severity was assessed using an 11-point numerical rating scale (NRS) from 0 to 10, with higher scores indicating greater severity. Additionally, participants self-reported the intensity of pruritus associated with LP using a similar 11-point NRS. Participants completed four validated self-administered questionnaires to assess various dimensions of QoL: Cutaneous body image scale (CBIS),&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; Dermatology Life Quality Index (DLQI),&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Skindex-16 &lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; and EuroQol-5 Dimension-5 Level (EQ-5D-5L) and EQ-VAS.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The CBIS rates mental perceptions of skin, hair, and nails on a 10-point scale, generating scores from 0 to 9, categorized as ‘severe’ CBI dissatisfaction for scores below 3, ‘moderate’ for 3 to 6, and ‘mild to none’ for scores above 6.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; The DLQI, comprising 10 items, measures a skin condition's impact over the past week, scoring from 0 to 30, with higher scores indicating increasing impact on QoL.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Higher scores indicate a greater impact on QoL: 0−1 means no effect, 2−5 a small effect, 6−10 a moderate effect, 11−20 a very large effect, and 21−30 an extremely large effect. The Skindex-16 evaluates skin disease impact through 16 items, divided into symptoms, feelings, and functioning, scoring from 0 to 100.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The EQ-5D-5L assesses health across five dimensions, which are evaluated to determine the EQ-5D-5L index. This is done using a scoring algorithm based on a value set obtained from valuation tasks commonly conducted with samples from the general population. The EQ-5D-5L index ranges from −0.59 to 1, where one represents optimal health, and negative values indicate states worse than death.&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The data analysis utilized International Business Machines Statistical Product and Service Solutions Statistics version 25. Descriptive statistics summarized demographic characteristics, disease severit","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1690-1693"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatoid neutrophilic dermatitis","authors":"Biagio Scotti,&nbsp;Cosimo Misciali,&nbsp;Yuri Merli,&nbsp;Federico Bardazzi,&nbsp;Diego Abbenante,&nbsp;Emi Dika,&nbsp;Bianca M. Piraccini","doi":"10.1002/jvc2.500","DOIUrl":"10.1002/jvc2.500","url":null,"abstract":"<p>Rheumatoid neutrophilic dermatitis (RND) is a dermatological condition typically associated with rheumatoid arthritis (RA). The low prevalence of RND and the wide spectrum of its possible clinical appearances make the diagnosis challenging. Current literature is still lacking a comprehensive overview of this rare cutaneous disorder. The aim of this review is to summarize data from the existing literature on RND, focusing on its epidemiology, clinical manifestations, histopathology and treatment. Hence, a comprehensive literature search of case reports and series was made, starting from a Medline (via PubMed) and Scopus databases. We also included in the analysis one patient attending to our dermatology department and diagnosed with RND. Overall, 54 cases of RND were identified. The majority of patients were female (72.3%) with a median (IQR) age at the time of diagnosis of 58 (65-45) years. RND followed the onset of RA in 87% of patients with an average (SD) latency time of approximately 10 (8.9) years. In 1 (1.8%) case the dermatitis preceded the appearance of joint symptoms, while in three (5.5%) cases it occurred concomitantly with them. Seropositive RA was the major associated form (76.5%). Clinically, asymptomatic papules (31%), nodules (15.1%) and/or plaques (13.5%) distributed bilaterally on extremities were most frequently described. Notably, females were more prone to develop a painful dermatitis (84.6%) compared to males. The vesicobullous (12.7%) and pustular (9.2%) clinical subtypes were the most demonstrative in contrast to the urticarial skin manifestations and the potential figurative/annular distribution of the lesions. Spontaneous resolution of RND was rare (5.5%). Systemic treatments, mainly represented by steroids and anti-neutrophilic agents (dapsone, colchicine), were consistently required.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1364-1380"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.500","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease severity in moderate-to-severe plaque psoriasis: Results from the Belgian REDISCOVER study","authors":"Tom Hillary,&nbsp;Liesbeth F. E. Ghys,&nbsp;Fabienne Willaert,&nbsp;Sandra Swimberghe,&nbsp;Myriam Lecuyer,&nbsp;Pierre-Dominique Ghislain,&nbsp;Joachim Morrens,&nbsp;Jo Lambert","doi":"10.1002/jvc2.488","DOIUrl":"10.1002/jvc2.488","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the Belgian DISCOVER study, conducted in 2011–2012 before the advent of the IL-17 and IL-23 Inhibitors, significant undertreatment of patients with plaque psoriasis was reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The present study aimed to re-evaluate the real-world clinical management and quality of care of moderate-to-severe plaque psoriasis patients treated with systemic treatment for at least 24 weeks in clinical practice in Belgium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional and retrospective chart review (REDISCOVER) was conducted in 2021–2022 in private practices and hospitals in Belgium. Patient data were collected during one single visit and included assessments of psoriasis severity (Psoriasis Area Severity Index [PASI], Body Surface Area [BSA], Pruritus VAS scale) and Health-Related Quality of Life (Dermatology Life Quality Index [DLQI]) and other selected criteria of the Belgian treat-to-target (T2T) outcome set.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 306 patients included in the study, 81.4% received treatment with biologicals and 18.6% with traditional systemics, that is, methotrexate or apremilast. IL-23 Inhibitors (33.7%) and methotrexate (10.8%) were the most prescribed biologicals and traditional systemic, respectively. Between the time of treatment initiation and enrolment, the average PASI and BSA scores decreased, indicating treatment benefits. PASI scores were lower in patients treated with biologicals versus patients treated with traditional systemics. Full achievement of the two Belgian T2T guidelines dimensions was observed in 51% of the patients. Nonetheless, patients were generally satisfied with their treatment (96.1%) and physicians evaluated the treatment as adequate for most patients (87.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared to 10 years ago, a demonstrable improvement in care of moderate-to-severe psoriasis patients was observed in Belgium. This was reflected by substantial achievement of the current treatment goals and high treatment satisfaction by both patients and physicians. While one out of five patients is not achieving targeted goals, and is not treated with a biological, it seems there is still room for improvement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1487-1498"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}