JEADV clinical practice最新文献

{"title":"Sun Protective Clothing: A Cross-Sectional Analysis of Online Availability","authors":"Nicola Kearney, Mary Laing","doi":"10.1002/jvc2.616","DOIUrl":"https://doi.org/10.1002/jvc2.616","url":null,"abstract":"<p>Skin cancer is the most common cancer in the UK and Ireland, with the number of non-melanoma and melanoma skin cancer diagnoses in the UK expected to rise by 39% [<span>1</span>] and 9% [<span>2</span>] by 2040, respectively. The World Health Organisation (WHO) advocates for the use of photoprotective clothing including wide-brimmed hats, tightly woven clothing, and wraparound style sunglasses that provide 100% ultraviolet-A (UV-A) and ultraviolet-B (UV-B) protection to combat the deleterious effects of UV radiation and increasing skin cancer rates [<span>3</span>]. The photoprotective standard of clothing is often measured as the ultraviolet photoprotective factor (UPF). UPF measures skin erythema at various UV radiation doses, and is analogous to the SPF of sunscreen [<span>4</span>]. UPF is defined as the ratio of the average effective UV irradiance calculated for unprotected skin, to the average effective UV irradiance calculated for skin protected by a given fabric [<span>5</span>]. The European Committee for Standardisation (CEN) has developed a standard on requirements for test methods and labelling of sun-protective garments. UV protective clothing for which compliance with this standard is claimed must have a UPF of greater than 40 (UPF 40+) and must maintain an average UVA transmittance of less than 5% [<span>6</span>]. We aimed to investigate the frequency of UPF-rated photoprotective clothing sold online by the United Kingdom's largest retailers.</p><p>The UK's top 30 retailers based on annual revenue generated were identified for the year 2023–2024 [<span>7</span>]. Each online retailer's website was searched for “UPF clothing” and “UPF” between September and December 2024 (Table 1). Seven online retailers were excluded as they did not sell clothing; the remaining 23 retailers were included for analysis in this study. Of the 23 remaining stores, 35% (8/23) sold UPF-rated clothing online. Three retailers sold UV protective clothing for men, women, and children, while this photoprotective clothing was less widely available on the remaining 5 retailer's online catalogues. Of the stores that did have UPF-rated clothing, 50% (4/8) had fewer than 15 UPF-graded items for sale; 25% (2/8) had over 200 UPF-graded items on their website. All UPF-rated clothing identified from these retailers websites were rated UPF 40+ or above, thereby complying with the CEN's guidance on UV protective clothing. The stores that had a selection of UPF-rated clothing on their website included Amazon, H&M, John Lewis, JD Sports, NEXT, House of Fraser, Screwfix and Very. The vast majority of UPF rated clothing identified were activewear and children's swimwear; there was a scarcity of “every day” casual clothing with a UPF rating.</p><p>Our online search of UPF-rated garments revealed that this photoprotective clothing is not readily available, with only 35% of the UK's largest online retailers stocking UPF-rated clothing. The poor availability of UPF-grade","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"577-579"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.616","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191062","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":"Refractory Pyostomatitis Vegetans With Multiple Aseptic Cutaneous Abscesses Successfully Treated With Filgotinib in Ulcerative Colitis","authors":"C. Dandoy,&nbsp;D. Franchimont,&nbsp;C. Delvaux,&nbsp;A. Buggenhout,&nbsp;D. Bernardi,&nbsp;V. Del Marmol,&nbsp;J. M. L. White","doi":"10.1002/jvc2.597","DOIUrl":"https://doi.org/10.1002/jvc2.597","url":null,"abstract":"<p>We report on a 31-year-old male patient diagnosed with active moderate-to-severe ulcerative colitis and a history of splenectomy. He was hospitalized due to confluent pustular oral lesions and multiple skin abscesses. After ruling out an infection, we diagnosed pyostomatitis vegetans associated with aseptic abscess syndrome. After multiple unsuccessful treatments (corticosteroids, infliximab, ciclosporin, ustekinumab and colectomy), filgotinib, a JAK 1 inhibitor, was then initiated, resulting in the complete resolution of skin lesions.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"507-509"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191135","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":"Real-life retrospective multicentre study to describe the use of dupilumab in paediatric patients with atopic dermatitis in Spain: Patient profile, effectiveness and safety","authors":"Eulalia Baselga Torres,&nbsp;Marta Ivars,&nbsp;Carolina Prat,&nbsp;Asunción Vicente,&nbsp;Marta Feito Rodríguez,&nbsp;Rocío Maseda Pedrero,&nbsp;Ana Martín Santiago,&nbsp;Aniza Giacaman,&nbsp;Antonio Torrelo Fernández,&nbsp;Lucero Noguera-Morel,&nbsp;Isabel Betlloch Mas,&nbsp;Laura de Berbegal Gracia,&nbsp;Montserrat Évole Buselli,&nbsp;Mónica Pozuelo Ruiz,&nbsp;José Bernabéu Wittel,&nbsp;María T. Monserrat García,&nbsp;Minia Campos Domínguez,&nbsp;Cristina Galache Osuna,&nbsp;Jorge Santos-Juanes Jiménez,&nbsp;Altea Esteve Martínez,&nbsp;Violeta Zaragoza Ninet,&nbsp;Miquel Casals Andreu,&nbsp;Sara I. Palencia Pérez,&nbsp;José Suárez Hernández,&nbsp;Sara Dorta Alom,&nbsp;Laura Feliciano Divasson,&nbsp;Ana Batalla Cebey,&nbsp;Manuel Galán Gutiérrez,&nbsp;Raúl de Lucas Laguna","doi":"10.1002/jvc2.565","DOIUrl":"https://doi.org/10.1002/jvc2.565","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dupilumab, inhibiting interleukin 4 and 13, is the first monoclonal antibody licensed for atopic dermatitis (AD) since 6 months of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The study describes the patients' profile, the effectiveness and safety in real life of dupilumab in adolescents with moderate-severe AD and children with severe AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>National, multicentre, observational, and retrospective study, based on medical records' data extracted in September 2023. Patients included were adolescents (12–17 years) with moderate-severe AD (Eczema Area and Severity Index [EASI] ≥ 16) and children (6–11 years) with severe AD (EASI ≥ 21) at the start of dupilumab therapy and treated with dupilumab for at least 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 211 analysed patients, at dupilumab treatment onset, 69.6% registered an Investigator's Global Assessment (IGA) = 4, a median Dermatology Life Quality Index (DLQI) = 17, and a median Peak Pruritus Numerical Rating Scale (PP-NRS) = 8. Atopic comorbidities were present in 69.7% of the patients. Overall, 97.1% of the patients had received systemic treatments before dupilumab, being oral corticosteroids (75.5%) the most frequent. At 16 and 52 weeks, the mean EASI percentage reductions from baseline were −77.5% and −84.7%, respectively, and 71.8% and 82.4% of the patients achieved EASI ≤ 7. A total of 70.5% and 36.5% (16 weeks), and 78% and 48.4% (52 weeks) of the patients had EASI-75 and EASI-90, respectively. At week 52, 70% and 87% of the patients achieved a reduction of ≥4 PP-NRS points and of ≥6 DLQI points, respectively. No serious dupilumab-related adverse events were reported; 6.2% presented treatment-related conjunctivitis and 1.4% reported eosinophilia, but without treatment discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study population had a pronounced disease burden as defined by signs, symptoms, quality of life, atopic comorbidities, and the systemic treatments' use prior dupilumab. In a short time (16 weeks), dupilumab treatment demonstrated clinically relevant improvement with an acceptable safety profile, continued over 52 weeks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"416-424"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.565","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190895","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":"Mental Health and Well-Being Support for Individuals Living With Skin Conditions: A Global Landscape Analysis of Patient Needs and Current Resources","authors":"Tammi Shipowick,&nbsp;Jennifer Austin,&nbsp;Nicole Sudiacal,&nbsp;Stephanie Miller,&nbsp;Jennifer A. Pereira,&nbsp;Christine Bundy","doi":"10.1002/jvc2.606","DOIUrl":"https://doi.org/10.1002/jvc2.606","url":null,"abstract":"<p>The impact of skin diseases can be devastating, encompassing physical symptoms such as bumps, rashes, hyper- or loss of pigmentation, redness, itch, pain and scarring. The consequences on mental health and well-being are often more detrimental, impacting the ability to conduct routine daily activities and engage socially. Given the prevalence of dermatological conditions, it is critical that resources are available to address these needs. We conducted a review of dermatology patient advocacy groups and health organizations’ websites to determine what types of resources to support mental health and well-being currently exist globally for individuals with skin conditions and identified 26 websites featuring resources such as sections dedicated to providing mental health information, programs on mental health topics and coping strategies, peer support forums, and counselling. Clinical trials and observational studies have demonstrated that many of these tools improve key mental health and well-being-related symptoms. In order for new and existing resources to be effective on a global scale, they should be delivered through methods that are sensitive to a spectrum of mental health-related stigma, and cultural beliefs. In parts of the world where individuals value privacy above openly speaking about one's feelings, or where smartphone adoption is ubiquitous (i.e., Europe, South-East Asia), digital health resources might hold the most potential for uptake. In regions such as Africa, and remote and rural Western Pacific, task-shifting, a process whereby laypeople are trained by health professionals to deliver community-based interventions, may be a promising format given mental health professional shortages. To provide optimal support for the mental health and well-being of those around the world with skin conditions, future efforts should focus on evaluation of the patient benefits offered by existing resources, and their adaptation and expansion to befit other world regions, and align with varied cultural needs and beliefs.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"595-611"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.606","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190887","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":"Allergic Contact Dermatitis to a Temporary Henna Tattoo","authors":"Hashim S. Kaderbhai,&nbsp;Marlous L. Grijsen","doi":"10.1002/jvc2.612","DOIUrl":"https://doi.org/10.1002/jvc2.612","url":null,"abstract":"<p>A 23-year-old healthy Somali woman presented at our hospital in Nairobi, Kenya, with firm blisters on both forearms that appeared 48 h after applying a henna tattoo for a traditional wedding (Figure 1 A,B). She had experienced similar, albeit milder, symptoms following a henna tattoo application 2 years prior, which had resolved spontaneously. The distinct history and clinical presentation led to the diagnosis of allergic contact dermatitis to para-phenylenediamine (PPD). Treatment involved topical corticosteroids. Epicutaneous patch testing was not available nor affordable in our setting.</p><p>PPD is a potent sensitizer commonly found in hair and textile dyes and is increasingly used in temporary henna tattoos to extend longevity, expedite the drying process and intensify the colouring [<span>1</span>]. The patient's re-exposure to PPD triggered a delayed-type hypersensitivity reaction. Henna is a natural dye derived from the <i>Lawsonia inermis</i> plant and is a weak sensitizer. It has been used for centuries in Africa, Asia and the Middle East for medicinal and decorative purposes and typically lasts 5−7 days [<span>2</span>]. The increasing popularity of long-lasting temporary henna tattoos containing PPD has been associated with an increase in reported allergic skin reactions [<span>1</span>]. Reports indicate that the concentration of PPD in henna tattoos is alarmingly high, often exceeding regulated levels [<span>3</span>], further elevating the risk of allergic reactions.</p><p>H.S.K. drafted the manuscript, and M.L.G. critically revised it. Both authors reviewed and approved the final manuscript and gave consent for publication.</p><p>The authors have nothing to report. The patient in this manuscript has provided written informed consent for the use of her deidentified anonymized data and her case details (including photographs) for publication. Ethical Approval: not applicable.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"333-334"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530170","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":"Access to Emollients in Atopic Dermatitis","authors":"Stephanie-Lynn Ryan,&nbsp;Cristina Grechin,&nbsp;Richard Watchorn","doi":"10.1002/jvc2.601","DOIUrl":"https://doi.org/10.1002/jvc2.601","url":null,"abstract":"&lt;p&gt;In addition to symptoms, the management of atopic dermatitis (AD) can significantly impact quality of life. Chronic disease can present a considerable financial burden for patients and families. The cost of treatment can lead to poor adherence and contribute to social inequality in access to care.&lt;/p&gt;&lt;p&gt;Emollients represent a cornerstone of therapy in AD. Van Zuuren et al.'s [&lt;span&gt;1&lt;/span&gt;] Cochrane review established that moisturisers reduced the number of flares, prolonged the interval between flares and reduced the need for corticosteroids. In addition, they reported that a combination therapy of moisturisers and topical corticosteroids were more effective than topical corticosteroids alone.&lt;/p&gt;&lt;p&gt;Despite the inclusion of emollients in all clinical guidelines and the frequency of their prescription, few are covered on General Medical Services (GMS) and the Drug Payment Scheme (DPS) in Ireland, presenting financial barriers for many. A search of reimbursable items on the HSE website [&lt;span&gt;2&lt;/span&gt;] reveals that Emulsifying ointment, Silcocks base and Aqueous cream—an emollient no longer recommended in AD due to its sodium lauryl sulphate (SLS) content—are reimbursed, whereas paraffin gel, Hydromol, Doublebase cream, Epaderm, CeraVe, E45 and Aveeno are not. Research suggests that individuals with atopic dermatitis should avoid SLS-containing products as it can exacerbate symptoms by disrupting the already compromised skin barrier, leading to irritation and inflammation and increased erythema, pruritis and dryness.&lt;/p&gt;&lt;p&gt;In contrast, commonly prescribed topical steroids such as Dermovate, Betnovate, Dovobet, Elocon and Eumovate are reimbursed. The reason for this discrepancy is unclear. In Ireland, patients can apply for reimbursement of a product not on formulary under the Discretionary Hardship Scheme, however, each application is assessed on a case-by-case basis.&lt;/p&gt;&lt;p&gt;Quantification of the out-of-pocket cost to the patient merits consideration. Patients on lower incomes may struggle to afford emollients, with resultant disparities in access based on socioeconomic status. Qualification for healthcare coverage such as medical cards can also significantly impact access. The Irish Skin Foundation advises that the typical minimum quantity of emollient required by a child with AD is 250 g of ‘leave-on’ emollient per week, while that of an adult is approximately 500 g per week. The cost of a 500 g tub of paraffin gel is 14.65 euros at the time of writing. This equates to 14.65 euros per week or 761.80 euros per year if an adult patient were to adhere to the Irish Skin Foundation advice [&lt;span&gt;3&lt;/span&gt;]. Launois et al. [&lt;span&gt;4&lt;/span&gt;] found that for patients with AD, the cost associated with emollients is significantly higher in patients with severe AD relative to those with moderate or mild AD.&lt;/p&gt;&lt;p&gt;Studies across Europe suggest that out-of-pocket costs for patients with AD is an issue of international scope. In France, Launois et al. [&lt;span&gt;","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"556-557"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190793","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":"Association Between A1c and Cutaneous Dermatophytosis: A Case–Control Study","authors":"Nicole Ufkes,&nbsp;Zachary Hopkins,&nbsp;John Skylar Westerdahl,&nbsp;Scott R. Florell","doi":"10.1002/jvc2.610","DOIUrl":"https://doi.org/10.1002/jvc2.610","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with diabetes have an increased risk of certain dermatophytoses. However, less is known about dermatophyte infections in pre-diabetic patients, or how A1c impacts risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Assess the relationship between recent (&lt; 1 year) HgbA1c status and odds of cutaneous dermatophyte infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Case–control study of patients seen at the University of Utah Dermatology Department between January 1, 2015 and December 21, 2022. Tinea cases were identified by ICD-10 codes and required the diagnosis be made by a dermatologist. Controls included patients seen in the dermatology department but who had no known diagnosis (past or current) of dermatophyte infection and were seen in a context where tinea could have been identified (i.e., no surgical visits, suture removals, spot checks, and cosmetic visits) and did not have a potentially confounding condition (inflammatory rashes). The primary exposure examined was averaged HgbA1c 1 year before index visit. Secondary exposures included HgbA1c 3 months, 3–6 months, and 6–12 months before visit as well as 3 months after the visit. Sensitivity analysis was performed using categorised Hgb A1c and historical diagnosis of diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a 1.16-fold increase in the odds of tinea per point increase in averaged pre-visit A1c (odds ratio [OR] 1.16; confidence interval [CI] 1.11–1.22). The odds of tinea for a given HgbA1c were higher for cutaneous tinea as compared to onychomycosis and tinea capitis. The odds of tinea were attenuated when adjusting for age and sex but remained significant (OR = 1.09; CI 1.03–1.15).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was an association between averaged HgbA1c over the year before a visit and odds of tinea infection. This association was similar for individual A1c periods and was more pronounced for tinea infections outside of onychomycosis and tinea capitis. These data may support HgbA1c screening in patients with new dermatophytoses, or conversely may increase the suspicion of cutaneous dermatophytosis if HgbA1c is elevated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"463-470"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191200","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":"Skin Diseases in Long-Distance Runners","authors":"Henna Ahomies,&nbsp;Vincent Descamps,&nbsp;Stéphanie Leclerc-Mercier,&nbsp;Nicolas Kluger","doi":"10.1002/jvc2.613","DOIUrl":"https://doi.org/10.1002/jvc2.613","url":null,"abstract":"<p>Long-distance running, including both road running and trail/mountain running, has significantly increased in popularity in recent years. The prolonged, repetitive physical activity combined with environmental exposures predisposes runners to a range of dermatological problems. We reviewed the dermatological challenges faced by long-distance runners, focusing on the prevalence, causes, and prevention of common skin conditions as well as risks related to ultra-violet radiation. Understanding these skin conditions and the circumstances surrounding running is essential for prevention and effective management. We present the existing literature on (i) environmental, (ii) traumatic or mechanical, (iii) inflammatory and infectious skin diseases, and (iv) the exacerbation of pre-existing dermatoses in long-distance running. Special consideration is given to the risk of skin cancer due to ultra-violet radiation and the photoprotection habits of endurance runners.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"378-388"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191192","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":"Lack of Evidence for the Efficacy of Antifungal Medications to Treat Atopic Dermatitis: A Systematic Review","authors":"Luis F. Andrade,&nbsp;Teresa Ju,&nbsp;Parsa Abdi,&nbsp;Michael R. Anderson,&nbsp;Elise Edwards,&nbsp;Nicole Khalil,&nbsp;Olivia Burke,&nbsp;Daniella Jaguan,&nbsp;Jonathan I. Silverberg","doi":"10.1002/jvc2.604","DOIUrl":"https://doi.org/10.1002/jvc2.604","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atopic dermatitis (AD) is characterised by immune dysregulation and skin-barrier dysfunction, which can predispose to microbial dysbiosis and skin infections. Fungi, particularly Malassezia, are common skin colonisers in AD patients and may exacerbate the condition. Previous studies on the efficacy of antifungal treatments for AD have shown inconsistent results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This systematic review aims to evaluate the effectiveness of topical and oral antifungal therapies in treating AD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted following the PRISMA guidelines (PROSPERO ID: CRD42022338791). Databases searched included PubMed, MEDLINE, Embase, Scopus, LILACS, Cochrane, CINAHL, GREAT, and ClinicalTrials.gov. Inclusion criteria encompassed interventional studies using antifungal agents for AD, with outcomes such as SCORing Atopic Dermatitis (SCORAD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 35,591 studies obtained from the initial search, seven met the inclusion criteria. Topical antifungal treatments, such as sertaconazole, miconazole, and ciclopirox olamine, showed minimal efficacy in reducing AD severity when compared to placebo or hydrocortisone treatments. Oral antifungal treatments, including itraconazole and ketoconazole, demonstrated mixed results, with some studies showing modest improvements in SCORAD scores but overall lacking significant clinical benefit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The systematic review found weak evidence supporting the efficacy of both topical and oral antifungal therapies for treating AD. Topical antifungals showed limited improvement and fewer adverse effects, while oral antifungals posed a higher risk of systemic adverse events without consistent efficacy. Based on these findings, antifungal treatments are not recommended for AD severity management alone other than for treatment of comorbid fungal and yeast infections. Future research should focus on larger sample sizes, standardised severity assessments, and comprehensive adverse event reporting to better evaluate antifungal treatments in AD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"400-406"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191264","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":"Rapid clearance of cutaneous lesions with anifrolumab in SLE (systemic lupus erythematosus) and DLE (discoid lupus erythematosus)","authors":"E. Parriel,&nbsp;C. Bulai-Livideanu,&nbsp;M. Severino-Freire,&nbsp;A. Delpuech,&nbsp;S. Faguer,&nbsp;J. Belliere,&nbsp;A. Huart,&nbsp;C. Paul","doi":"10.1002/jvc2.590","DOIUrl":"https://doi.org/10.1002/jvc2.590","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs, including the skin. Activation of the Type I interferon pathway is a key pathophysiological factor in SLE. Discoid lupus erythematosus (DLE) is a chronic cutaneous form of lupus and treatment is challenging with an increased risk of disfigurement and poor quality of life. Treatment of cutaneous manifestations is challenging and current standard therapies remain inadequate. Anifrolumab is a monoclonal antibody that targets the Type 1 interferon receptor subunit 1. Phase III clinical trials (TULIP-1, TULIP-2 and MEDI-546) have demonstrated its efficacy in reducing SLE activity and improving lupus-associated skin manifestations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this retrospective study was to provide information on the early effect of anifrolumab in patients with cutaneous manifestations of lupus with and without systemic involvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study evaluating the early effect of anifrolumab in six patients with refractory cutaneous manifestations of lupus, including those with DLE with and without associated SLE. The outcome measure was the change in Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) score at 1–2 months. Photographs were performed before and after treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean baseline CLASI score was 14.2 ± 10.6 (median: 10.5). At 1–2 months, the CLASI score was 5.7 ± 5.3 (median: 3.0). The clinically remarkable efficacy was visible in most patients after the first injection of anifrolumab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We observed the rapid efficacy of anifrolumab within the first 2 months in patients with refractory cutaneous manifestations of SLE and CLE. Limitations include the small sample size and lack of a control group. Overall, anifrolumab represents a potential therapeutic option for severe or resistant cutaneous lupus and warrants further investigation. Research is needed to determine its optimal use and efficacy in different cutaneous lupus subtypes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"207-215"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.590","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530671","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}