JEADV clinical practice最新文献

{"title":"Absence of HPV in Verrucous Psoriasis Lesions","authors":"A. A. Cabanillas-Cabral, S. Becerril-Andrés, L. Bejarano-Antonio, G. Baeza-Hernández, J. Cañueto-Álvarez, A. Santos-Briz","doi":"10.1002/jvc2.605","DOIUrl":"https://doi.org/10.1002/jvc2.605","url":null,"abstract":"<p>The clinical spectrum of psoriasis may be variable and verrucous lesions have rarely been observed [<span>1</span>]. Verrucous psoriasis is characterized by the combination of both patterns of psoriasis and verruca vulgaris [<span>2</span>]. To our knowledge, the involvement of human papillomavirus (HPV) in verrucous psoriasis has not been evaluated at a molecular level. Therefore, we searched the electronic pathology database of the Complejo Asistencial Universitario de Salamanca (CAUSA) for patients diagnosed with verrucous psoriasis from the 1st of January, 2012 to the 31st of December, 2023 and identified six biopsies from five patients. There were three males and two females (age range: 41−65 years). Skin biopsies revealed an epidermis with marked irregular hyperplasia, parakeratosis, hypogranulosis, papillomatosis, suprapapillary atrophy, intracorneal neutrophils and exoserosis. All these findings were considered consistent with verrucous psoriasis (Table 1, Figure 1). The presence or absence of HPV in the lesions was evaluated through DNA extraction techniques and complete genotyping real time PCR to detect and identify the specific HPV involved in the lesion. Sections were obtained from paraffin blocks. The results were negative in all cases except one, which showed presence of HPV 182.</p><p>Verrucous psoriasis is a rare type of psoriasis with fewer than 40 published cases. From a clinical perspective, it is characterized by the presence of papules and verruciform hyperkeratotic plaques located in the extensor surfaces. Several clinical subtypes have been described, such as annular or unilateral verrucous psoriasis [<span>3-5</span>]. These lesions typically appear in patients who had been previously diagnosed with psoriasis [<span>2</span>]. This disease is generally diagnosed in midlife [<span>6</span>]. Histopathology of verrucous psoriasis is characterized by papillomatous epidermal hyperplasia without acanthosis, parakeratotic hyperkeratosis, reduced granular layer, atrophy of the suprapapillary epidermis with dilated vessels in the dermis and superficial inflammatory lymphocytic infiltrate [<span>2</span>]. Therefore, it is characterized by presenting psoriasiform dermo-epidermal changes, with papillomatosis as a sign that differentiates it from other clinical forms of psoriasis. There is usually presence of intracorneal neutrophil aggregates and exoserosis [<span>2</span>].</p><p>Differentiation between verrucous psoriasis and viral warts may be challenging. Additionally, verrucous psoriasis may be confused with verrucous carcinoma [<span>7</span>]. Verrucous psoriasis may resemble rupioid psoriasis in some patients [<span>8</span>], but the hyperkeratosis is verruciform in verrucous psoriasis and resenmobes an adhered oyster shell in rupioid psoriasis.</p><p>The role of HPV in verrucous psoriasis has been ruled out through histological (H&E stains) and immunohistochemical studies, without other specifical techniques [<span","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"564-566"},"PeriodicalIF":0.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190753","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":"The Impact of Regularly Used Treatments on Daily Life of Cutaneous T-Cell and B-Cell Lymphoma Patients","authors":"Michelle Raaijmakers, Marlies Meersman, Leen Neyens, Anne-Marie Busschots, Pascal Wolter, F. J. Sherida H. Woei-A-Jin","doi":"10.1002/jvc2.599","DOIUrl":"https://doi.org/10.1002/jvc2.599","url":null,"abstract":"<p>Primary cutaneous lymphoma (PCL) has a significant impact on patients' quality of life (QoL) as several aspects of the disease affect patients' physical and psychosocial wellbeing [<span>1-3</span>]. Early stage mycosis fungoides (MF) patients, the largest group within PCL, generally show slow disease progression and long survival, but spend a large amount of their life receiving treatment [<span>4</span>]. Meanwhile, treatment burden is hardly represented in existing quantitative QoL instruments and so far, qualitative research only briefly touched this topic and never included indolent primary cutaneous B-cell lymphoma (CBCL) or primary cutaneous anaplastic large cell lymphoma (pcALCL) [<span>5, 6</span>].</p><p>We conducted semi-structured in-depth interviews in 19 MF/SS (Sézary Syndrome), 2 CBCL and 1 pcALCL patients visiting our outpatient clinic to get a deeper understanding of the challenges and needs across disease stages and PCL subtypes (Table 1). In accordance with previously published qualitative data, CTCL patients experienced diagnostic delay, disease symptoms, multiple consecutive therapies in search for one that worked (Table 2, Q1), shame and a large impact on daily (social) life [<span>5</span>]. Interestingly, indolent CBCL patients also reported feelings of shame and avoidance behavior (Q2). In contrast with previously published reports, the majority of interviewed patients in Belgium found the large psychosocial impact of regularly used treatments an important theme. Patients especially reported a significant impact of treatment with PUVA, interferon-alpha (IFNα), radiotherapy and carmustine ointment on their daily life.</p><p>Most IFNα-treated patients described debilitating fatigue and exhaustion (Q3–Q4). Even in an outpatient setting, the frequent injections significantly hampered everyday activities. Patients mentioned not being able to work fulltime, go on holidays or leave their home as easily as before (Q5). Some patients reported IFNα-induced irritability, increased anxiety and panic attacks (Q6). Treatment impact was especially high for carmustine ointment. Patients complained about the product's greasiness, ‘getting in their clothes and bed sheets’ and dreaded having to apply the product every evening (Q7). Several patients found it hard to stay motivated to adhere to treatment, especially when lesions already disappeared (Q8). Because of the toxicity of topical chemotherapy patients slept separately from their partners, which was frequently mentioned as an inconvenience (Q9). Some PUVA-treated patients reported malaise or nausea as an important issue (Q10). Treatment interfered with patients' daily activities as they were expected to undergo this therapy multiple times a week, which made it time-consuming and forced patients to plan their life around it (Q11). Radiotherapy was also considered time-consuming, especially for patients living further away from the hospital. A few patients reported burned skin and pa","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"552-555"},"PeriodicalIF":0.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190822","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":"Pott Puffy Tumour: A Case to Look Beyond the Nose","authors":"Virginie Lucidarme, Erwin Suys, Michiel Bonny, Stephanie Verschuere","doi":"10.1002/jvc2.607","DOIUrl":"https://doi.org/10.1002/jvc2.607","url":null,"abstract":"<p>An 85-year-old man presented with a painless lesion on the bridge of the nose that had been present for 6 months. He described that the lesion started as a large lump with pus and blood oozing from it. As with previous treatments, we note topical disinfectant products and various antibiotic treatments, none of which have led to a cure. The patient felt well and reported no other complaints. During clinical examination, we saw a sunken erythematous erosive lesion that was noticeably adherent to the surrounding tissue on palpation (Figure 1). This made us want to rule out a connection with underlying structures (such as the bone/sinuses). A sinus CT (Figure 2) was performed and showed chronic frontal sinusitis and a Pott puffy tumour (PPT). To rule out the possibility that it was a coincidental combination of chronic sinusitis and a malignancy, a biopsy (Figure 3) of the lesion was taken, which showed reactive changes with a hyperplastic epidermis and a florid dermal infiltrate with an important plasmocytic component without atypia. Additional immunohistochemical staining for kappa and lambda light chains showed a normal kappa/lambda ratio, demonstrating the polyclonal nature of the plasma cells. There was no histological evidence for underlying epithelial or haematological malignancy. PPT is a rare diagnosis. It is characterised by the presence of a subperiosteal abscess arising from frontal bone osteomyelitis. Sir Percival Pott first described the condition in 1768 and referred to the observable swelling with the word ‘tumour’ (one of the four components of inflammation), rather than to neoplasia. It is characterised by a circumscribed, tender swelling at the forehead mostly presenting with other associated symptoms including fever, headache, nasal discharge or increased intracranial pressure. Most frequently, it is a complication of acute or chronic sinusitis. Other possible causes are head trauma, dental infection, cocaine abuse and head surgery [<span>1</span>]. Various bacteria can be associated with PPT, with the most frequent being nonenterococcal streptococci (47%), anaerobic oral bacteria (28%) or staphylococci (22%) [<span>1</span>]. The type of bacteria involved influences how quickly symptoms appear. Organisms such as Actinomyces and anaerobes tend to cause slower onset of symptoms compared to more aggressive microbes like <i>Staphylococcus aureus</i> or those causing mucormycosis, which lead to faster symptom development [<span>2</span>]. The differential diagnosis of a frontal swelling includes epidermoid cyst, musculus frontalis-associated lipoma, dermoid cyst, infected haematoma and benign or malignant tumours of the skin, bone or frontal sinuses [<span>3</span>]. Because of the high frequency of intracranial complications, PPT can be life-threatening. As soon as there is suspicion, rapid imaging (CT or MRI) should be obtained [<span>4</span>]. A bacterial swab is also recommended to guide subsequent antibiotic treatment. Treatm","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"567-569"},"PeriodicalIF":0.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190821","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":"Androgenetic Alopecia Is not Associated With Major Vascular Comorbidities: A Retrospective Case-Control Study of 8230 Patients","authors":"Michael M. Ong, Steven Zeldin, Brendan Stone, Shari R. Lipner","doi":"10.1002/jvc2.608","DOIUrl":"https://doi.org/10.1002/jvc2.608","url":null,"abstract":"<p>Androgenetic alopecia (AGA) affects approximately 80% of men and approximately 50% of women during their lifetimes [<span>1</span>]. There are reported associations between early-onset (≤ 35-years-old) AGA, and cardiovascular diseases, including hypertension and coronary artery disease (CAD) [<span>2-4</span>]. We examined for potential associations of vascular conditions with early onset AGA by sex to help stratify AGA patients who may benefit from early cardiovascular intervention.</p><p>AGA patients were identified from the All of Us database 5/6/2018–12/31/2023. Systematised Nomenclature of Medicine codes identified vascular diagnoses. Each AGA case was matched to nine controls based on age, sex, and race using nearest-neighbour propensity score matching. Unpaired <i>t</i>-tests and Fisher's exact tests compared continuous and discrete variables, respectively. Wald's test applied to multivariate logistic regression calculated odds ratios (ORs) and <i>p</i>-values. Age, sex, race, hyperlipidemia, obesity, and smoking were covariates in regression analyses. Benjamini–Hochberg adjusted for multiple hypothesis testing with false discovery rate ≤ 0.05.</p><p>We included 823 AGA patients and 7407 controls. AGA patients had mean age 60.30-years, with 68.65% female and 72.42% White (Table 1). Of AGA cases, 143 (17.4%) were early onset, with average age 33.43-years, 28.7% female, and 72.0% White. Baseline characteristics were similar between groups (<i>p</i>-values > 0.05). Hypertension, CAD, and varicose veins were the most common comorbidities for AGA and early onset AGA patients (Table 2). In multivariate models, overall and early onset AGA patients had increased risk of varicose veins (aOR = 1.51, <i>p</i> = 0.02; aOR = 7.91, <i>p</i> = 0.02, respectively), but no other vascular diseases (<i>p</i>-values > 0.05). With sex sub-analysis, increased varicose vein risk persisted for overall and early onset AGA men (aOR = 3.22, <i>p</i> = 0.02; aOR = 10.70, <i>p</i> = 0.02, respectively), but not women (aOR = 1.37, <i>p</i> = 0.19; aOR = 3.55, <i>p</i> = 0.99, respectively).</p><p>We found that male AGA, particularly early onset AGA, was associated with higher risk of varicose veins versus controls, but not other major vascular diseases. In contrast, in a retrospective case-control study of 85 males who underwent coronary revascularization, patients with early onset AGA (≤ 35-years-old) versus non-AGA patients or with later-onset AGA (> 35-years-old) had increased likelihood of coronary revascularization before 60-years-old (aOR = 3.18, 95%CI:1.01–10.03) [<span>4</span>]. Furthermore, a meta-analysis of nine studies including 44,806 patients (88.9% AGA) reported that men with AGA versus without hair loss had increased heart disease risk (RR = 1.32, 95%CI:1.08–1.63), especially younger men (< 55-years-old) (RR = 1.44, 95%CI:1.11–1.86) [<span>5</span>].</p><p>AGA was associated with increased varicose vein risk for only males, which to our ","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"570-573"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.608","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190696","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":"SARS-COV2 Vaccination and Hidradenitis Suppurativa: Role of Vaccination in Disease Activity","authors":"E. Molinelli, E. De Simoni, D. Gambini, A. Maurizi, S. Belleggia, M. L. Dragonetti, G. Rizzetto, A. Offidani, O. Simonetti","doi":"10.1002/jvc2.598","DOIUrl":"https://doi.org/10.1002/jvc2.598","url":null,"abstract":"<p>Hidradenitis suppurativa (HS) is a severe chronic debilitating inflammatory skin disease of the hair follicle unit that usually presents with painful abscesses, nodules, tunnels and scars in intertriginous areas [<span>1, 2</span>]. Several factors including heat, physical activity, sweating, shaving, premenstrual phase and friction are key players of HS exacerabations [<span>3</span>]. Environmental factors, such as infections and vaccinations, stimulating the immune system could act as a trigger for disease flare. In recent years, a global vaccine campaign against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was launched, and the role of anti-SARS-Cov2 vaccination as trigger for HS flares has been extensively debated [<span>3-5</span>].</p><p>We conducted a retrospective study that evaluated the incidence and the characteristics of disease flares in patients with HS who received anti-SARS-CoV-2 vaccination. Data were collected between April 2020 and December 2022 by teledermatology interview, initially preferred due to social distance, or by face-to-face visits when possible. A total of 222 patients, which received at least one dose of COVID-19 vaccine were examined. one hundred and fifty-three patients (68.9%) were vaccinated with BNT162b2 vaccine, 43 (19.4%) with mRNA-1273 vaccine, 16 (7.2%) with ChAdOx1nCoV-19 vaccine, 5 with Ad26.COV2.S vaccine, 4 (1.8%) received the BNT162b2- ChAdOx1nCoV-19 combination, and one patient (0.5%) received the mRNA-1273- BNT162b2 combination (Table 1). Flare was defined as exacerbation of HS occurring within 2 weeks after the onset of SARS-CoV-2 vaccination. Flares after anti-SARS-CoV-2 vaccine were observed in 21 (9.5%) patients, with a mean latency onset of 8.9 days. HS flares positively correlated with a higher Hurley stage at univariate analysis (<i>p </i> = 0.021). Acute flares were reported among 2.3% (1/42) of patients with Hurley Stage I, 9.1% (14/154) of patients with Hurley Stage II, and 23.1% (6/26) of patients with Hurley Stage III. No association with type of vaccination was observed. No correlation with the concomitant treatment for HS was detected, except for biologic treatment that was associated with a lower risk of flare (non-flares vs. flare: 43.8% vs. 4.8%, respectively; <i>p</i> = 0.034). Although not statistically significant, a positive correlation between female sex and flares was observed (non-flares vs. flares: 88.2% vs. 11.8%, respectively; <i>p</i> = 0.08) (Table 2).</p><p>The role of vaccination in HS exacerbations is still discussed. Few case reports described the exacerbation of HS after SARS-CoV-2 vaccination, considering the efficacy and safety of SARS-CoV-2 vaccine in patients with immune-mediated inflammatory diseases [<span>6-8</span>]. Recently, Liakou et al. evaluated the occurrence of flares and new related lesions of HS following SARS-Cov2 vaccination in a retrospective study including 250 HS patients. HS flares occurred in 48 patients (19.2%) following","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"323-326"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530765","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 and Sustained Improvement of Lichen Planus Pemphigoides With the JAK1 Inhibitor Upadacitinib","authors":"Louise Gueissaz,&nbsp;Ronald Wolf,&nbsp;Christoph Schlapbach","doi":"10.1002/jvc2.603","DOIUrl":"https://doi.org/10.1002/jvc2.603","url":null,"abstract":"<p>Lichen planus pemphigoides (LPP) is a rare autoimmune blistering disorder characteris ed by lichenoid plaques and blister formation. Current treatments are often ineffective, and there is a lack of standardised guidelines. The disease's pathogenesis involves both T-cell-mediated lichenoid dermatitis and autoantibody formation, presenting treatment challenges, especially in refractory cases. While previous therapies have focused on immunosuppressive agents, many patients fail to achieve sustained remission. Here, we report a case of LPP successfully treated with the Janus kinase 1 (JAK1) inhibitor upadacitinib. The patient, a 56-year-old female with pruritic lichenoid lesions and blisters, experienced rapid symptom resolution following treatment. Notably, pruritus subsided within days, and both skin lesions and anti-BP180 antibody levels improved substantially within 1 month. Remarkably, the patient remained nearly symptom-free for 6 months posttreatment. This case demonstrates that JAK1 inhibition can offer rapid and sustained clinical improvement in LPP, with the potential for disease modification. These findings suggest that early, targeted intervention with JAK inhibitors may provide a new therapeutic avenue for autoimmune skin diseases, particularly those resistant to traditional treatments.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"525-528"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191060","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":"Dermoscopy of Fire Coral (Millepora) Sting: The Clock Sign","authors":"Fátima Mayo-Martínez,&nbsp;Ruggero Moro","doi":"10.1002/jvc2.609","DOIUrl":"https://doi.org/10.1002/jvc2.609","url":null,"abstract":"&lt;p&gt;This letter aims to illustrate the usefulness of dermoscopy in the diagnosis of fire coral (millepora) sting and describes a new dermoscopic sign related to fire coral anatomy. Fire corals, cnidarians belonging to the genus millepora, are hydrozoans frequently found in the Indian, Pacific, and Atlantic Oceans and the Caribbean Sea [&lt;span&gt;1&lt;/span&gt;]. Predatory polyps protruding from the skeleton are numerous and highly toxic, for this reason millepora are popularly known as “stinging corals” or “fire corals” [&lt;span&gt;2&lt;/span&gt;]. Direct skin contact with fire corals causes an immediate painful stinging reaction [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We report the case of a 34-year-old man consulting for pruritic, erythematous papules grouped in annular plaques on the medial malleolus of the right ankle (Figure 1A). The initial diagnostic impression was of annular granuloma. Surprisingly, dermoscopy showed fine black lines and dots arranged in multiple circular patterns. Moreover, scales and an erosion were present on an erythematous background (Figure 1B). Upon reevaluating the history, patient reported that a week earlier he had been scuba diving in the Dominican Republic. While underwater, he brushed against a hard object, experiencing pain from the impact but no burning sensation. Four days later, the skin lesions appeared. Dermoscopic and anamnestic findings resulted in the diagnosis of fire coral (millepora) sting.&lt;/p&gt;&lt;p&gt;Fire corals (millepora) are a genus of colonial polypoidal hydrozoans (hydrocorals) located in shallow tropical seas [&lt;span&gt;1, 2&lt;/span&gt;]. Millepora means “thousand pores”, because their skeleton is formed by numerous pores of two types: gastropores and dactylopores. Dactylopores are arranged in circles around individual gastropores [&lt;span&gt;2&lt;/span&gt;] (Figure 2). The dactylopores contain the dactylozooids, predatory polyps used to capture prey and defend against predators [&lt;span&gt;3&lt;/span&gt;]. Dactylozooids are covered with numerous fine, hair-like tentacles that enclose nematocysts containing stinging venom [&lt;span&gt;1, 2&lt;/span&gt;]. A physical trigger, for instance the contact with a foreign body, causes the ejection of microscopic filaments that penetrate the target organism, releasing its toxic contents [&lt;span&gt;1&lt;/span&gt;]. This circular arrangement of the dactytlozoids translates into the dermoscopic findings observed in the patient: several microscopic slender barbs (nematocysts) forming lines and dots arranged in multiple circular patterns, resembling each of them the face of a clock. Therefore, we propose the “clock sign” as the dermoscopic clue to diagnose millepora sting. Previously, dermoscopic features representing the penetration of jellyfish nematocysts have been reported, showing brown dots and lines irregularly distributed [&lt;span&gt;4-6&lt;/span&gt;]. Other observed features include an erythematous background and erosions due to scratching when pruritus is the predominant clinical manifestation, as it was in our case. The patient's mild symptoms can b","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"574-576"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191061","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":"Lichen Sclerosus Is Associated With Lichen Planus, Atopic Dermatitis, and Rheumatoid Arthritis in a Case-Control Study of 5020 Female and Male Patients","authors":"Kaya L. Curtis,&nbsp;Onajia Stubblefield,&nbsp;Miriam Keltz Pomeranz,&nbsp;Shari R. Lipner","doi":"10.1002/jvc2.592","DOIUrl":"https://doi.org/10.1002/jvc2.592","url":null,"abstract":"&lt;p&gt;Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disorder frequently involving the anogenital region. There is evidence of LS association with autoimmunity in female patients; however, few case-control studies have included male patients. Therapeutic options for LS are limited and comorbidity data is sparce [&lt;span&gt;1-4&lt;/span&gt;]. Understanding of LS associations may add insight into shared pathogeneses and expand the treatment armamentarium. We aimed to evaluate LS associations with comorbidities using a national database.&lt;/p&gt;&lt;p&gt;A nested case-control study using the National Institutes of Health &lt;i&gt;All of Us&lt;/i&gt; database was conducted analysing patients ≥ 18 years with LS and controls matched 1:4 by age, sex, and self-reported ethnicity/race. Multivariate logistic regression assessed odds ratios for LS and comorbidities.&lt;/p&gt;&lt;p&gt;There were 1004 LS patients and 4016 controls included in the final analysis. Mean age of LS patients was 68.2 years, 97.2% were female/other, and 87.9% of patients were white, with similar demographics for controls (&lt;i&gt;p&lt;/i&gt; = 0.99, &lt;i&gt;p&lt;/i&gt; = 1, &lt;i&gt;p&lt;/i&gt; = 1, respectively) (Table 1). LS was associated with lichen planus (LP) (OR 5.30; 95% CI 3.57−9.41; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), alopecia areata (AA) (OR 4.33; 1.73−11.47; &lt;i&gt;p&lt;/i&gt; = .001), vitiligo (OR 4.23; 2.85−10.96; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), atopic dermatitis (AD) (OR 2.37; 1.85−3.66; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and psoriasis (OR 2.18; 95% CI 1.61-2.89; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Results were similar for female LS patients, with additional association with rheumatoid arthritis (RA) (OR 1.58; 1.14−2.18; &lt;i&gt;p&lt;/i&gt; = 0.005) (Table 2). For male patients, LS was associated with psoriasis (OR 7.16; 1.66−30.77; &lt;i&gt;p&lt;/i&gt; = 0.008) and was not associated with AD or RA. LP, AA, and vitiligo associations in male LS patients could not be assessed due to small numbers. There was no LS association with ulcerative colitis.&lt;/p&gt;&lt;p&gt;Our study strengthens previously established LS associations, including AA, psoriasis and vitiligo [&lt;span&gt;1, 2&lt;/span&gt;], and relatively novel associations with LP, AD, and RA, potentially suggesting a shared pathogenesis. A recent case-control study [&lt;span&gt;4&lt;/span&gt;] of 43,000 female patients demonstrated LS association with LP (OR 10.30; 95% CI 5.02−19.0), AA (OR 6.86; 95% CI 5.65−8.33), vitiligo (OR 2.20; 95% CI 1.88-2.56), and AD (OR 1.14; 95% CI 1.09−1.20), but lower odds of psoriasis (OR 0.81; 95% CI 0.78−0.84) and rheumatoid arthritis (OR 0.38; 95% CI 0.36−0.41) versus controls.&lt;/p&gt;&lt;p&gt;The JAK/STAT pathway is involved in LP, AA, vitiligo, AD, psoriasis, and RA pathogenesis [&lt;span&gt;5-7&lt;/span&gt;]. Notably, in a clinical trial [&lt;span&gt;8&lt;/span&gt;] of 10 patients assessing abrocitinib, an oral JAK1 inhibitor, for LS treatment, all patients achieved disease control at week 12 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) and resolution of pruritus at week 4 (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). A double-blind, randomised, controlled trial assessing efficacy of topical ruxolitinib for LS (NCT05593445) is underway.&lt;/","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"327-330"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530684","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":"Localised Chronic Fibrosing Vasculitis in a 6 Year Old Boy Clinically Mimicking Dermatofibrosarcoma Protuberans","authors":"Michela Brena,&nbsp;Italo Francesco Aromolo,&nbsp;Nicola Adriano Monzani,&nbsp;Stefano Cambiaghi,&nbsp;Giorgio Alberto Croci,&nbsp;Chiara Benaglia,&nbsp;Riccardo Cavalli","doi":"10.1002/jvc2.595","DOIUrl":"https://doi.org/10.1002/jvc2.595","url":null,"abstract":"<p>This case outlines the stepwise evaluation of a growing plaque on the back of a 6-year-old boy mimicking dermatofibrosarcoma protuberans. Further investigations, including echography and two biopsies, led to the unexpected diagnosis of Localised Chronic Fibrosing Vasculitis, highlighting the importance of considering rare entities in challenging cases.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"519-521"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191109","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":"Eruptive Xanthomata Manifesting in Tattoos","authors":"Connor Stonesifer,&nbsp;Alexandra Morquette,&nbsp;Jeffrey N. Li,&nbsp;Scott A. Elman,&nbsp;George W. Elgart","doi":"10.1002/jvc2.594","DOIUrl":"https://doi.org/10.1002/jvc2.594","url":null,"abstract":"<p>Eruptive xanthomata represent a rare, but important pruritic dermatosis for which an accurate diagnosis can prevent life-threatening complications. We present the case of a 29-year-old female with no prior medical history who presented to clinic for evaluation of a pruritic papular eruption of 2 weeks' duration. Notably, examination revealed numerous papules within the boundaries of her long-standing tattoos. Biopsy of these lesions revealed a diagnosis of eruptive xanthomata. Eruptive xanthomata are observed in the setting of extreme hypertriglyceridemia (&gt; 3000 mg/dL) and, importantly, they koebnerize to areas of acute and past trauma. Examination of tattoos is vital in dermatologic practice as changes, particularly induration, can be suggestive of systemic disease. This case emphasises that the differential of koebnerization within tattoos should include eruptive xanthomata.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"522-524"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.594","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191110","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}