JEADV clinical practice最新文献

{"title":"A Case of Anti-TNFα Therapies Induced Lupus Panniculitis Successfully Improved With a JAK Inhibitor (Baricitinib)","authors":"Cristina Grechin,&nbsp;Jane Doheny,&nbsp;Keith Pilson,&nbsp;Donough Howard,&nbsp;Muireann Roche","doi":"10.1002/jvc2.626","DOIUrl":"https://doi.org/10.1002/jvc2.626","url":null,"abstract":"<p>Lupus erythematosus panniculitis (LEP) is a rare variant of cutaneous lupus erythematosus (1%–3% of CLE). There are two case reports to date in the literature of LEP potentially triggered by anti-TNF-α therapies. Clinically, it is characterised by tender, erythematous subcutaneous indurated nodules or plaques on fatty body areas. It can occur frequently alone or in combination with systemic erythematous lupus or discoid lupus. The pathogenic mechanism of anti-TNF-α therapies induced lupus panniculitis is not well understood. Our case report and literature review highlight that anti-TNF-α therapies can induce lupus panniculitis, especially in the rheumatoid arthritis cohort of patients.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"540-543"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.626","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191173","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":"Successful Psoriasis Management With Deucravacitinib After Guselkumab-Associated Eosinophilic Pneumonia","authors":"Katie K. Lovell,&nbsp;Steven R. Feldman","doi":"10.1002/jvc2.614","DOIUrl":"https://doi.org/10.1002/jvc2.614","url":null,"abstract":"<p>Eosinophilic pneumonia (EP) involves the accumulation of eosinophilic infiltrates in the lung parenchyma, potentially triggered by smoking, infections, or medications, including biologics for psoriasis. This case report describes a 49-year-old female with a history of psoriasis and chronic pancreatitis, who developed EP after initiating guselkumab, an IL-23 inhibitor. Following a 4-month hiatus from ustekinumab due to insurance issues, she received guselkumab for a psoriasis flare (60% BSA). Shortly before the second dose, she presented with pleuritic chest pain, cough, and shortness of breath. CT revealed extensive ground-glass infiltrates, and bronchoscopy with bronchoalveolar lavage (BAL) showed 52% eosinophils, indicating EP. Two months postdischarge, follow-up CT showed near-complete resolution of opacities, and 4 months later, after tapering off of systemic corticosteroids, her psoriasis flared again (60% BSA). Due to EP and preference for a nonbiologic treatment, deucravacitinib, a TYK2 inhibitor, was initiated, resulting in well-controlled psoriasis (BSA = 0%) after 3 months, with only mild, resolved acne. This case suggests deucravacitinib as a viable option for patients experiencing noninfectious pneumonia from prior biologic therapy and highlights the importance of monitoring for pulmonary symptoms in patients on biologics.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"529-531"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.614","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191174","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":"Erythematoviolaceous Papules and Plaques on Sun-Exposed Areas","authors":"Ana C. Martín-Zamora,&nbsp;Alejandra Gamboa-Flores,&nbsp;Jaime Pozuelo-Díaz,&nbsp;Marcela Campos-Hidalgo","doi":"10.1002/jvc2.618","DOIUrl":"https://doi.org/10.1002/jvc2.618","url":null,"abstract":"&lt;p&gt;A 71-year-old Hispanic female patient presented to the dermatology department with a 6-year history of cutaneous lesions. Personal medical history was notable for hypertension, diabetes mellitus, and previous breast cancer. Her chronic treatment consisted of metformin, insulin, irbesartan and omeprazole. She reported lesions appearing first on her scalp and face with significant pruritus and then extending to the back of her upper extremities, with worsening after sun-exposure. Previous treatment with topical and oral steroids had a poor response.&lt;/p&gt;&lt;p&gt;On physical examination, erythematoviolaceous papules and plaques, some with annular configuration and diffuse white scaling were seen (Figure 1). Dermoscopy revealed shiny white structures in some areas. In other parts, a pinkish–red background with whitish scales, orange–yellow structureless areas, and a mixed vascular pattern (dotted, linear and branched vessels) was evidenced (Figure 2).&lt;/p&gt;&lt;p&gt;Laboratory testing revealed anaemia (haemoglobin: 11.1 mg/dL) with normal leucocyte and platelet count. Kidney and liver function tests were normal. Positive antinuclear antibodies (ANA) and extractable nuclear antigen antibodies (ENA) were found, with detection of Anti-Ro and Anti-La antibodies. Anti-ds-DNA antibodies were negative. No other lab anomalies were detected. Skin biopsies from her back and left arm were done (Figure 3).&lt;/p&gt;&lt;p&gt;CLE/LP overlap syndrome is very rare, with few cases published so far. Diagnostic criteria define classic CLE/LP overlap syndrome as patients with mixed clinical characteristics of both CLE and LP, histopathological characteristics consistent with LP (with or without CLE features), and positive serologic markers of CLE (positive ANA with 1:80 or higher titers, ENA antibodies, double-stranded DNA antibodies, or antiphospholipid antibodies) [&lt;span&gt;1, 2&lt;/span&gt;]. Our patient fulfilled all the criteria. Direct immunofluorescence (DIF) can be helpful, but is not necessary for diagnosis, and can present features of either CLE or LP [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;According to literature, cutaneous lesions in this entity most often affect the extremities, face, and trunk. They have been described as centrally atrophic, hypopigmented, with scaling, sometimes painful or pruritic [&lt;span&gt;3, 4&lt;/span&gt;]. However, a wide variety of different morphologies have been reported, with oral compromise also being present in many cases [&lt;span&gt;2&lt;/span&gt;]. Our patient presented with lesions in photo-exposed areas, some of them morphologically consistent with lichen planus and some more suggestive of psoriasiform subacute cutaneous lupus. She also presented autoantibodies more commonly found in the subacute form of CLE. The coexistence of these findings has been reported before [&lt;span&gt;5, 6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In addition to presenting clinical overlapping features of both CLE and LP, dermoscopic findings in our patient were also consistent with both conditions. Classic dermoscopic elements described in subac","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"621-623"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.618","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191170","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":"Management of Cutaneous Lesions in Brunsting–Perry Pemphigoid (Bpp): A Single-Center Retrospective Cohort Study","authors":"Shirley P. Parraga,&nbsp;Matthew L. Hrin,&nbsp;Sarah N. Rimmer,&nbsp;Joseph L. Jorizzo","doi":"10.1002/jvc2.70000","DOIUrl":"https://doi.org/10.1002/jvc2.70000","url":null,"abstract":"&lt;p&gt;Brunsting–Perry pemphigoid (BPP) is a rare, autoimmune skin disorder within the spectrum of mucous membrane (cicatricial) pemphigoid characterized by subepidermal blistering of the head, neck, and shoulders [&lt;span&gt;1, 2&lt;/span&gt;]. The development of autoantibodies against hemidesmosomal proteins including BP180 and BP230 disrupts the integrity of the epidermal basement membrane [&lt;span&gt;2-4&lt;/span&gt;]. BPP's rarity has precluded extensive study [&lt;span&gt;4, 5&lt;/span&gt;]. We assessed the outcomes of 10 BPP patients treated with methotrexate (MTX) or mycophenolate mofetil (MMF).&lt;/p&gt;&lt;p&gt;Institutional review board was obtained to review the medical records of patients evaluated at Wake Forest Baptist Health's dermatology clinic who received MTX or MMF for BPP skin lesions between 2010 and 2020. Diagnoses were established based on (1) clinical features of lesions, (2) positive direct immunofluorescence (DIF) assays (&lt;span&gt;&lt;/span&gt;&lt;math&gt;\u0000 &lt;semantics&gt;\u0000 &lt;mrow&gt;\u0000 &lt;mrow&gt;\u0000 &lt;mo&gt;±&lt;/mo&gt;\u0000 &lt;mspace&gt;&lt;/mspace&gt;\u0000 &lt;/mrow&gt;\u0000 &lt;/mrow&gt;\u0000 &lt;/semantics&gt;&lt;/math&gt;C3 deposits along the basement membrane zone), (3) histopathologic findings, and (4) ELISA/immunoblot positivity. Patients who did not meet these criteria were excluded. Outcomes were categorized as complete response (CR) (asymptomatic, no new lesion development), partial response (PR) (improving lesions, reduced erythema and inflammation), and no response (NR).&lt;/p&gt;&lt;p&gt;Our patients were primarily White (100%) males (60%) with a mean age of 62 years (range: 48–82) (Table 1). Lesions were presented on the trunk (40%), face (20%), mouth (70%), scalp (40%), and genitals (10%) (Figure 1). Patients had face (25%), scalp (50%), and buccal mucosal biopsies (25%) (Figure 2). Seven patients (70%) had positive ELISA results for IgG antibodies against full-length BP 180 recombinant proteins; four patients (40%) had positive anti-BP 230 IgG antibodies. All patients (100%) had negative antibody production against collagen VII. Patients had a mean disease duration of 27 and 42 months before MTX and MMF initiation, respectively. Medications failed before MTX or MMF included topical corticosteroids (30%), prednisone (30%), tacrolimus “swish and spit” (20%), magic mouthwash (hydrocortisone, lidocaine, diphenhydramine, nystatin) (30%), doxycycline (20%), minocycline (10%), dapsone (10%), and azathioprine (10%). Seven patients (70%) were systemic therapy naïve. Three patients (30%) had pretreatment systemic therapy failure on a mean prednisone dose of 21.7 mg.&lt;/p&gt;&lt;p&gt;Two treatment groups were analyzed: MTX and MMF. Patients received either MTX or MMF as initial treatment. Six patients received treatment with MTX; four with MMF (Table 2). One patient was discontinued from MTX and started on MMF. Mean time to initial response was 2.9 months (standard deviation [SD], 1.9 months) and 2.7 months (SD, 2.4 months) for ","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"580-583"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191193","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":"An Evaluation of Generic and Disease-Specific Patient-Reported Outcome Measures to Assess the Impact of Percentage of Scalp Hair Loss on Health-Related Quality of Life in a European Population","authors":"K. A. Hanson,&nbsp;S. Marwaha,&nbsp;S. K. Kurosky,&nbsp;M. Harries,&nbsp;P. Anderson,&nbsp;J. Piercy,&nbsp;V. Basey,&nbsp;J. Austin,&nbsp;E. H. Law","doi":"10.1002/jvc2.591","DOIUrl":"https://doi.org/10.1002/jvc2.591","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hair loss due to alopecia areata (AA) can negatively impact patients’ health-related quality of life (HRQoL). Patient-reported outcome measures (PROMs) like the EQ-5D-5L and the Alopecia Areata Patient Priority Outcomes (AAPPO) represent treatment outcomes and can guide decision-making. However, the EQ-5D-5L potentially underestimates AA-specific impacts, while the AAPPO may provide a more disease-specific assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study uses the EQ-5D-5L and the AAPPO emotional symptom (ES) and activity limitations (AL) subscales to characterise HRQoL among patients with AA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This analysis uses secondary data from the Adelphi Alopecia Areata Disease Specific Programme (AA-DSP), a survey of dermatologists and patients with AA in five European countries. Included patients completed a survey containing the EQ-5D-5L and AAPPO. Descriptive summary statistics were reported for AAPPO ES/AL subscales and EQ-5D-5L scores, overall and stratified by physician-reported percentage of scalp hair loss (%SHL). Cramer's V effect sizes were calculated across each of the AAPPO ES/AL and EQ-5D anxiety/depression and usual activities items to examine the relationship between varying degrees of SHL and the PROMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four hundred thirty-five patients with AA completed the AAPPO and EQ-5D-5L. The mean (SD) overall EQ-5D-5L index and EQ-VAS score was 0.85 (0.15) and 74.07 (17.86), respectively. The mean (SD) overall AAPPO ES and AL subscale scores were 1.70 (1.03) and 0.88 (0.93), respectively. For the AAPPO ES and AL items, effect sizes were largest between the extreme values of SHL (0%–10% vs. 100%), while the effect sizes between intermediate SHL groups (e.g., 11%–20% and 21%–49%) tended to be smaller. The two EQ-5D-5L items demonstrated lower effect size values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest the AAPPO suitably discriminates between clinically relevant groups of patients with AA. The EQ-5D-5L was not as effective in measuring the specific psychological or social dimensions by SHL, potentially underestimating disease burden among patients with AA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"451-457"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191246","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":"Postoperative Pyoderma Gangrenosum After Breast Surgery: A Single-Centre Retrospective Study","authors":"Shirley P. Parraga,&nbsp;Jonathan D. Greenzaid,&nbsp;Matthew L. Hrin,&nbsp;Wasim A. Haidari,&nbsp;Kyle E. Robinson,&nbsp;Lindsay C. Strowd","doi":"10.1002/jvc2.624","DOIUrl":"https://doi.org/10.1002/jvc2.624","url":null,"abstract":"&lt;p&gt;Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis sometimes induced by trauma, including surgical procedures, through a process known as pathergy [&lt;span&gt;1&lt;/span&gt;]. Breast surgery accounts for roughly 25% of postoperative PG (PSPG) cases [&lt;span&gt;1&lt;/span&gt;]. Identifying factors associated with developing PSPG is critical for facilitating early recognition and timely intervention [&lt;span&gt;2, 3&lt;/span&gt;]. In this study, we analysed the characteristics of patients who developed PSPG after breast surgery at our academic medical centre.&lt;/p&gt;&lt;p&gt;Institutional review board was obtained to review the medical records of patients evaluated at Atrium Health Wake Forest Baptist's dermatology clinic between 2010 and 2024 who were diagnosed with PG after breast surgery. A 2:1 randomized control cohort of patients who underwent similar procedures and did not develop PG was utilized for comparison. Parameters analysed included demographics, comorbid conditions, surgical procedures and characteristics, risk factors and postoperative complications. Statistical significance between the PSPG and control cohort was compared.&lt;/p&gt;&lt;p&gt;The PSPG (&lt;i&gt;n&lt;/i&gt; = 11) and control cohort (&lt;i&gt;n&lt;/i&gt; = 22) had similar demographic characteristics (Table 1). Associated medical conditions included previous episodes of PG (9% PSPG vs. 0% control, &lt;i&gt;p&lt;/i&gt; = 0.33), prior malignancy (55% PSPG vs. 100% control, &lt;i&gt;p&lt;/i&gt; = 0.002), and inflammatory arthritis (55% PSPG vs. 18% control, &lt;i&gt;p&lt;/i&gt; = 0.05). Patients also had inflammatory skin disorders (36% PSPG vs. 5% control, &lt;i&gt;p&lt;/i&gt; = 0.033). Only eczema and psoriasis were identified. No patients in either cohort had a history of leukaemia, lymphoma, or inflammatory bowel disease (Table 1). Patients more frequently developed PSPG following breast reconstruction (55% vs. 5%, &lt;i&gt;p&lt;/i&gt; = 0.0025) and reduction (45% vs. 5%, &lt;i&gt;p&lt;/i&gt; = 0.0096) compared to the control cohort (Table 1). No differences in suture type were observed between the cohorts (Table 1). The average time between surgery and the onset of PG symptoms was 3.91 months. Seven patients (64%) developed symptoms within 90 days of surgery.&lt;/p&gt;&lt;p&gt;Classic surgical risk factors were higher for PSPG patients compared to the control cohort (Table 1). Body mass index (BMI) was greater for PSPG patients (33.6 kg/m&lt;sup&gt;2&lt;/sup&gt;) compared to the control group (26.6 kg/m&lt;sup&gt;2&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt; = 0.0063). The PSPG cohort had more current or former smokers (63% vs. 41%, &lt;i&gt;p&lt;/i&gt; = 0.28), diabetics (36% vs. 18%, &lt;i&gt;p&lt;/i&gt; = 0.39) and a longer duration of surgical procedure (323 min vs. 226 min, &lt;i&gt;p&lt;/i&gt; = 0.21), although these characteristics were not statistically significant. Mean estimated blood loss (EBL) was comparable for both groups.&lt;/p&gt;&lt;p&gt;Initial versus successful treatments for PSPG patients were also evaluated (Table 2). Most patients were initially treated with systemic antibiotics (73%) and debridement (45%, Table 2) for an average duration of 9.6 months before starting therapy with syste","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"584-586"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.624","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191195","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":"Prolonged Vancomycin-Induced Linear IgA Disease in a Patient With Renal Failure","authors":"Kaori Takezawa,&nbsp;Reiko Noborio,&nbsp;Yuki Nomura,&nbsp;Takahiro Kiyohara,&nbsp;Mako Mine,&nbsp;Takashi Hashimoto","doi":"10.1002/jvc2.622","DOIUrl":"https://doi.org/10.1002/jvc2.622","url":null,"abstract":"<p>A 64-year-old man with pneumococcal septic shock and subsequent renal failure underwent treatments with antibiotics including intravenous vancomycin (VCM). Blistering skin lesions appeared 10 days after the initiation of VCM. When the patient was transferred to us 5 months later, blisters with erythema were still observed on the abdomen and thighs. Histopathological examination revealed subepidermal blister with infiltration of eosinophils and neutrophils, and direct immunofluorescence revealed linear IgA deposition at the basement membrane zone. The diagnosis of linear IgA disease (LAD)was made, and drug-induced LAD by VCM was suspected, because of the episode of the blister development 10 days after the first VCM administration. Although the results of various sero-immunological tests were negative, IgA reactivity with type Ⅶ collagen was detected by VCM-treated ELISA, which further suggested the diagnosis of VCM-induced LAD. The possible mechanism for the prolonged disease course was speculated.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"535-539"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.622","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191189","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":"Where Is Waldo?","authors":"Lilia Maria Lima de Oliveira,&nbsp;Uzma Farooq,&nbsp;Samir Ahmad,&nbsp;Naiara Fraga Braghiroli","doi":"10.1002/jvc2.620","DOIUrl":"https://doi.org/10.1002/jvc2.620","url":null,"abstract":"<p>A 76-year-old man presented to the clinic for a total body examination. He had a personal history of five melanomas in situ, five basal cell carcinomas, and three squamous cell carcinomas. The dermatological examination revealed sun-damaged skin with three similar irregular brown macules on the left superior back, left medial trapezium, and mid-upper back (Figure 1). Dermoscopy of the three macules was comparable, revealing multicomponent features (Figure 1).</p><p>A biopsy was performed, and histology revealed one melanoma in situ and two solar lentigo (Figure 2). The melanoma was subsequently excised with 5 mm margins. Currently, the patient is being closely monitored.</p><p>In this case study, the three macules exhibited clinical and dermoscopic features that could be attributed to the diagnosis of melanoma. The presence of several nevi, extensively sun-damaged skin, and a significant history of skin cancer made the diagnosis even more challenging. Digital monitoring enables close observation and timely intervention, but in patients with suspected lesions of melanoma, early surgical excision is key. This case highlights the importance of a complete skin check and the challenge of diagnosing pigmented skin lesions in patients with severe sun damage.</p><p><b>Lilia Maria Lima de Oliveira:</b> conceptualization, drafting and reviewing the manuscript, and final approval of the submitted version. <b>Uzma Farooq:</b> conceptualization, drafting and reviewing the manuscript, and final approval of the submitted version. <b>Samir Ahmad:</b> conceptualization, drafting and reviewing the manuscript, and final approval of the submitted version. <b>Naiara Fraga Braghiroli:</b> conceptualization, drafting and reviewing the manuscript, and final approval of the submitted version.</p><p>All patients in this manuscript have given written informed consent for participation in the study and the use of their de-identified, anonymized, aggregated data and their case details (including photographs) for publication. Ethical approval is not applicable.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"593-594"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.620","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191196","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":"Interleukin-12/23 and Interleukin-23 Inhibitors for the Treatment of Cutaneous Crohn's Disease: A Case Series From a Multi-Institutional Registry","authors":"G. E. McKay,&nbsp;A. Coromilas,&nbsp;L. Liu,&nbsp;K. S. Shaw,&nbsp;M. Murphy,&nbsp;N. Punyamurthy,&nbsp;K. M. Santiago Soltero,&nbsp;W. Damsky,&nbsp;K. A. Wanat,&nbsp;A. P. Charrow,&nbsp;M. Rosenbach,&nbsp;A. Caplan,&nbsp;C. E. LaSenna,&nbsp;L. Arkin,&nbsp;B. E. Shields","doi":"10.1002/jvc2.615","DOIUrl":"https://doi.org/10.1002/jvc2.615","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cutaneous Crohn's disease (CCD) is a granulomatous condition of the skin discontiguous from the gastrointestinal tract. Cutaneous disease rarely correlates with intestinal disease and often requires separate treatment. While the use of interleukin-12/23 (IL-12/IL-23) and interleukin-23 (IL-23) inhibitors is FDA-approved for intestinal Crohn's disease (CD), there is limited data for CCD. We retrospectively reviewed the clinical features of 24 cases of CCD treated with risankizumab as monotherapy, ustekinumab as monotherapy, or ustekinumab in combination with vedolizumab from seven academic institutions across the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective of this study was to evaluate the impact of IL-12/23 or IL-23 inhibitor therapy on CCD independent of intestinal disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were identified by retrospective review of the electronic health record including histopathologic diagnosis consistent with CCD. At least one visit with a dermatologist between 2000 and 2020 was required. Chart review collected demographic, clinical and histologic data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 24 adult and paediatric patients with CCD treated with IL-12/IL-23 inhibitor therapy. Most patients were White (21/24, 88%), female (20/24, 83%), had intestinal CD (19/24, 79%), were diagnosed with intestinal CD before CCD diagnosis (18/24, 75%), and were on biologic therapy before CCD diagnosis (16/24, 67%). Most patients failed to respond to treatment with anti-tumour necrosis alpha (anti-TNF) therapy before IL-12/IL-23 inhibitor therapy (22/24, 92%). Of the 24 patients treated with ustekinumab, less than half (7/24, 29%) were simultaneously treated with vedolizumab. Four adult patients (4/24, 17%) were treated with risankizumab monotherapy. At the date of the last follow-up with a dermatologist, over a third (8/24, 33%) of patients' skin was reported as complete clearance by physician note.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We propose that IL-12/IL-23 and IL-23 inhibitor therapy be considered as therapy for the treatment of TNF-blockade refractory CCD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"458-462"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191207","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":"Emergence of bullous pemphigoid under treatment of mycosis fungoides with mogamulizumab","authors":"Lukas D. Uleer,&nbsp;Carmen Loquai,&nbsp;Iakov Shimanovich,&nbsp;Cyrus Khandanpour,&nbsp;Jasper N. Pruessmann,&nbsp;Patrick Terheyden,&nbsp;Christian D. Sadik","doi":"10.1002/jvc2.570","DOIUrl":"https://doi.org/10.1002/jvc2.570","url":null,"abstract":"<p>Mycosis fungoides (MF) is the most common cutaneous T cell lymphoma. Since 2018, mogamulizumab, an antibody directed to to the chemokine receptor CCR4, is licensed for the treatment of MF. Treatment with mogamulizumab is associated with the precipiation of different types of skin rashes summarized as mogamulizumab-associated rash. Here, we report the emergence of severe bullous pemphigoid (BP) in a patient suffering from severe MF and treated with mogamulizumab. BP is an autoimmune blistering skin disease causing severe pruritus and subepidermal blisters and, consequently, erosions. It is driven by autoantibodies against BP180, a protein of the dermal-epidermal adhesion complex. The parallel occurrence of MF and BP led to a bizarre clinical and histopathological presentation blending features of MF and BP. Among others, the patient developed multiple large erosions with a diameter of up to 15 cm, and histopathology featured subepidermal clefts with a mixed dermal infiltrate and atypical lymphocytes forming a superficial dermal lichenoid infiltrate and showing epidermotropism, including above the subepidermal clefts. Immunopathology revealing linear depositions of IgG and C3 at the dermal-epidermal junction and very high serum levels of anti-BP180-NC16A IgG were instrumental to diagnose BP and to distinguish it from mycosis fungoides bullosa, an extremely rare variant of MF. This case illustrates that immunopathology for BP should be conducted in patients with MF developing pruritus and blisters, although both can also be a symptom of MF. Our case alone does not allow determining whether the emergence of BP under mogamulizumab treatment was a mere coincidence or was in a causal relationship. The latter scenario would at BP to the possible clinical presentations of mogamulizumab-associated rashes.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"503-506"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.570","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191255","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}