JEADV clinical practice最新文献

{"title":"ChatGPT for Pathology Reports in Cutaneous Lymphoma: Accuracy and Readability in Cutaneous Lymphoma","authors":"Jennifer Chen, Josiah Hanson, Oliver H. Chang, Michi M. Shinohara","doi":"10.1002/jvc2.602","DOIUrl":"https://doi.org/10.1002/jvc2.602","url":null,"abstract":"<p>Artificial Intelligence (AI) has become more powerful and more integrated in our everyday lives, including in health care. ChatGPT has been proposed as a tool to act as a virtual “health assistant”, by giving health information in “succinct, clear overviews in layman's terms” [<span>1</span>]. While AI can potentially fill in gaps in health care, there are concerns about the accuracy of information output. With limited resources and potentially difficult-to-understand information, patients with rare diseases such as primary cutaneous lymphoma may turn to ChatGPT for answers. In this study, we assessed the accuracy and readability of ChatGPT's interpretation of cutaneous lymphoma pathology reports.</p><p>We randomly chose 41 cutaneous lymphoma pathology reports from patients at the University of Washington and Fred Hutch Cancer Center. We provided ChatGPT-3.5 the final diagnoses, comments, and addendums from deidentified pathology reports with the command “Interpret this pathology diagnosis for me in layman's terms.” ChatGPT interpretations were evaluated by three dermatopathologists, and errors were classified as clinically significant or non-clinically significant based on if the error could potentially change diagnosis or management.</p><p>Out of the 41 evaluated reports, we found seven clinically significant errors and 20 non-clinically significant errors (Table 1). Examples of clinically significant errors are shown in Table 1b.</p><p>Figure 1 shows average readability scores and grade levels for original pathology reports and ChatGPT interpretations. On average, original pathology reports had a Flesch reading ease score of 16.6 ± 11.0, corresponding to a grade level of 14.9 ± 2.8, approximately a college graduate. ChatGPT interpretations had an average Flesch reading ease score of 43.5 ± 11.8, corresponding to a grade level of 12.0 ± 1.8, approximately high school graduate. The mean difference in Flesch reading ease scores between original pathology reports and ChatGPT interpretations was 26.9 [23.1–30.7] (<i>p</i> < 0.01), corresponding to a decrease in grade level by 2.8 [2.0–3.7] (<i>p</i> < 0.01).</p><p>We found that ChatGPT interpretation of pathology reports of cutaneous lymphomas generated errors that could impact patients' understanding of their diagnosis or management if patients relied on the ChatGPT interpretation alone. For example, a pathology report with the original diagnosis of “primary cutaneous follicular lymphoma” was interpreted by ChatGPT as “a type of cancer called follicular lymphoma that usually starts in the lymph nodes,” implying that the diagnosis is systemic rather than primary cutaneous lymphoma. Relying on this interpretation could potentially lead to additional anxiety or stress on the part of the patient and/or inappropriate treatment if relied upon by clinicians. The clinically significant error rate in our study is higher than previously reported for ChatGPT-4's interpretation of pathology reports [","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"561-563"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.602","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191181","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":"Risankizumab in Oncologic Patients With Psoriasis: A Case Series","authors":"Michela Magnano, Susanna Rossari, Emanuele Trovato, Eugenio Capalbo, Martina Dragotto, A. Di Cesare, Elia Rosi, Flavia Manzo Margiotta, Alessandra Michelucci, Salvatore Panduri, Federica Ricceri, Gionata Buggiani, L. Pescitelli, Elisa Lorenzoni, Barbara Simoni, Imma Savarese, Nicola Milanesi, Marco Romanelli, Pietro Rubegni, Francesca Prignano","doi":"10.1002/jvc2.600","DOIUrl":"https://doi.org/10.1002/jvc2.600","url":null,"abstract":"<p>The use of biologics in psoriatic patients with a history of malignancy is still a grey zone in the clinical practice. Guidelines recommend that these drugs should be avoided in subjects with a current or recently diagnosed malignancy, unless it has been treated more than 5 years earlier [<span>1</span>]. However, biologics may also be considered in patients with severe psoriasis and a recent diagnosis of malignancy (i.e., within 5 years) in a multidisciplinary joint decision with the oncologists. Still, due to the scanty literature on this topic, many clinicians prefer avoiding the use of biologics in oncologic patients, afraid of a possible relapse of the neoplasm. This concern is higher in patients who are candidate to interleukin (IL)-23 inhibitors (IL-23i), because there are no data regarding their use in oncologic patients.</p><p>We conducted a multicentric observational study of the use of risankizumab, a recently introduced IL-23i, in psoriatic and oncologic patients, with recent (i.e., < 5 years) or past (i.e., ≥ 5 years) diagnosis of malignancy, who attended the Outpatient Psoriasis of 8 referral centres in Tuscany, Italy. We collected a total of 11 patients (mean age 64.72 ± 9 years) (Table 1), of which five started the biologic before 5 years from the diagnosis of malignancy. In this latter group, two patients were diagnosed with breast cancer, one with prostatic adenocarcinoma, one with melanoma, and one with colorectal adenocarcinoma. One of the patients with breast cancer had also had a lung adenocarcinoma 9 years before. The mean time between the diagnosis of malignancy and the start of risankizumab was 33.6 ± 13.10 months. None of the patients experienced a relapse after a mean follow-up time of 14.4 ± 9.7 months (range 4–28 months). Six patients were treated with risankizumab after a diagnosis of malignancy was made a mean of 98.33 ± 62.23 months before. All patients were followed up for a mean of 11.16 ± 8.23 months without experiencing relapses. Ten patients out of 11 had been also treated with both systemic and biologic agents, before starting risankizumab. The mean PASI before therapy was 13.78, and all patients except one reached the PASI75 after 36 weeks of therapy. One patient withdrew the therapy after 9 months because of inefficacy.</p><p>Risankizumab is an IgG1 monoclonal antibody that binds to IL-23A with high affinity. It has shown an optimal safety profile during clinical trials, but in these trials patients with malignancy within 5 years were excluded [<span>2</span>].</p><p>Data about the progression of preexistent malignancies during therapy with risankizumab are scarce. Rusinol et al. [<span>3</span>] reported one patient treated with risankizumab with history of prostate cancer occurred 5 years earlier, who did not show disease progression. Another patient treated with risankizumab after only 2 months from a duodenal cancer diagnosis and followed for 96 weeks without experiencing relapses, was described b","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"558-560"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190730","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":"Stasis dermatitis and pigmented purpuric dermatoses: Histological characterization and review of literature","authors":"M. S. Hoffet,&nbsp;D. L. Perruchoud,&nbsp;K. Gadaldi,&nbsp;K. Heidemeyer,&nbsp;S. Bossart,&nbsp;L. Borradori,&nbsp;A. A. Ramelet,&nbsp;L. Feldmeyer","doi":"10.1002/jvc2.569","DOIUrl":"https://doi.org/10.1002/jvc2.569","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stasis dermatitis and pigmented purpuric dermatoses can both manifest as hyperpigmentation, petechiae and/or purpura on the lower extremities, posing a challenge for macroscopic differentiation. We investigated the histological differences in these two conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the histological characteristics of stasis dermatitis and pigmented purpuric dermatosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Skin biopsy specimens were obtained from seven patients with stasis dermatitis, 15 with pigmented purpuric dermatosis, and three control patients. The samples were analysed for histological changes (hematoxylin-eosin), melanin (silver nitrate), iron, elastic stain, and with an immunohistochemistry for melanocytes (Melan-A).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The predominant histological features of stasis dermatitis were hemosiderin deposits, eosinophils and telangiectasias. Pigmented purpuric dermatosis was characterized by extensive erythrocyte extravasation, interface changes and spongiosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The distinct histological characteristics of stasis dermatitis and pigmented purpuric dermatosis can improve the diagnostic classification of these entities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"166-173"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.569","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530649","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":"Pre-Operative Ultrasonography Guide for Hidradenitis Suppurativa","authors":"Redina Bardhi,&nbsp;Mohsen Mokhtari,&nbsp;Mavra Masood,&nbsp;Jasira Ziglar,&nbsp;Sydney Colbert,&nbsp;Iltefat Hamzavi,&nbsp;Indermeet Kohli","doi":"10.1002/jvc2.596","DOIUrl":"https://doi.org/10.1002/jvc2.596","url":null,"abstract":"&lt;p&gt;Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterised by abscesses, nodules, and sinus tracts [&lt;span&gt;1&lt;/span&gt;]. Although diagnostic and staging criteria for HS are based on clinical findings, this may underestimate the severity and extent of disease [&lt;span&gt;1&lt;/span&gt;]. High frequency ultrasound (HFU) has been shown to be highly sensitive when combined with clinical examination in delineating the extent of HS lesions [&lt;span&gt;1&lt;/span&gt;]. It provides important details on lesion morphology and severity, aiding in tracking disease progression and guiding treatment options. Thus, it has received a high-grade rating as a valid biomarker for HS [&lt;span&gt;2&lt;/span&gt;]. As such, pre-surgical margin mapping with HFU, before carbon dioxide (CO&lt;sub&gt;2&lt;/sub&gt;) laser surgery—an effective treatment for HS, may reduce recurrence rates. However, there is minimal existing literature regarding the margin mapping methodology. This letter provides a practical framework for ultrasound mapping of HS lesions before CO&lt;sub&gt;2&lt;/sub&gt; laser excision.&lt;/p&gt;&lt;p&gt;It is important to become familiar with ultrasound features of skin layers to delineate HS lesions from healthy tissue. In healthy skin, the epidermis is the outermost layer, appearing as a hyperechoic line [&lt;span&gt;3&lt;/span&gt;]. Beneath, lies the dermis, a thick and heterogeneous layer with hyperechoic reflections of collagen fibres [&lt;span&gt;3&lt;/span&gt;]. Lastly, the hypodermis sits below the dermis, appearing as a hypoechoic fat interdispersed with linear hyperechoic reflections representing connective tissue [&lt;span&gt;3&lt;/span&gt;]. Features of HS on ultrasound include increased dermal thickening, lower echogenicity of the dermis suggesting edema, anechoic or hypoechoic fluid deposits, and widening of hair follicles [&lt;span&gt;3, 4&lt;/span&gt;]. Additionally, fistulous tracts appear as anechoic or hypoechoic band-like structures in the dermis or hypodermis, while pseudocysts appear as oval-shaped hypoechoic or anechoic nodular structures [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Regarding HFU imaging specific to margin mapping before CO&lt;sub&gt;2&lt;/sub&gt; laser excision, the following methodology is recommended. After palpating the specific lesions to estimate extent, the US probe should be positioned perpendicular to the lesion. This should be done while applying minimal pressure and using the little finger to keep the hand steady and elevated, while in contact with the skin through a gel bed (Figure 1). A 1−2 cm gel bed is recommended for better visualisation of changes in superficial features [&lt;span&gt;5&lt;/span&gt;]. A lower frequency probe, such as 12 MHz, may be used initially to find deeper lesions, as these probes provide greater depth of imaging, although at a relatively lower resolution [&lt;span&gt;5, 6&lt;/span&gt;]. A higher frequency probe, with range from 15 to 22 MHz, may be utilised next to visualise areas of interest in greater detail [&lt;span&gt;5, 6&lt;/span&gt;]. Among the characteristic HFU features of HS, change in dermal thickening was identified as the mo","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"320-322"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.596","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530647","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":"Validity of the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) tool in a Dutch cohort of transplant recipients","authors":"Octavian I. Bacoș-Cosma,&nbsp;Grigory A. Sidorenkov,&nbsp;Daan Kremer,&nbsp;Tim J. Knobbe,&nbsp;Bert van der Vegt,&nbsp;Stephan J. L. Bakker,&nbsp;Emőke Rácz,&nbsp;TransplantLines Investigators","doi":"10.1002/jvc2.555","DOIUrl":"https://doi.org/10.1002/jvc2.555","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To identify patients with high risk of skin cancer, risk prediction tools have been developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>External validation of the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) in a Dutch cohort of solid organ transplant recipients (SOTR) and exploration of the possibility of incorporating additional risk factors to enhance its predictive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from the ongoing, prospective TransplantLines Biobank and Cohort Study of the University Medical Center Groningen (Groningen, The Netherlands). We conducted a survival analysis using Fine and Gray models to determine the subdistribution hazard ratios of the SUNTRAC risk factors and groups, Wolbers C index to assess its discriminative power, and cumulative incidences of skin cancer to assess its calibration. We applied the same methods for the incorporation of additional risk factors to the model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2099 patients were included with a median age at transplantation of 52.1 years (Interquartile range [IQR]: 40.6–60.1) and a median follow-up time of 6.6 years (IQR: 3.4–12.5). In total 478 (22.8%) patients developed skin cancer. Basal cell carcinoma (53.3%) and cutaneous squamous cell carcinoma (42.9%) were most prevalent. The cumulative incidences of skin cancer per SUNTRAC risk group at 10 years were: low-risk (1.8%), medium-risk (12.9%), high-risk (34.3%) and very high-risk (68.6%). Significantly different skin cancer risk rates were observed for the medium-risk (SHR = 9.9, 95% CI: 2.51–39.4), high-risk (SHR = 21.5, 95% CI: 5.40–85.2) and very high-risk (SHR = 80.3, 95% CI: 19.26–335.1) groups in reference to the low-risk group. Wolbers C-index at 5 years was 0.71. The model was well calibrated for our cohort. The addition of other potential risk factors yielded no or marginal improvement of discriminative value on top of SUNTRAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SUNTRAC is valid for the general Dutch SOTR population, and it can be clinically implemented.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"117-127"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.555","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530374","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":"Severe pemphigus vulgaris and cervical carcinoma treated with anti PD1 antibody pembrolizumab: A therapeutic dilemma?","authors":"Sophia Wasserer,&nbsp;Kristine Mayer,&nbsp;Svenja Rupp,&nbsp;Tilo Biedermann,&nbsp;Oliver J. Stoetzer,&nbsp;Moritz Hamann,&nbsp;Felix Lauffer","doi":"10.1002/jvc2.589","DOIUrl":"https://doi.org/10.1002/jvc2.589","url":null,"abstract":"<p>Managing autoimmune diseases (AIDs) in the context of malignancies and vice versa is an intricate challenge for clinicians. Immunotherapies stimulate antitumor immune responses by blocking checkpoint molecules such as PD1. However, new onset or aggravation of autoimmune reactions are frequent side effects of immunotherapies. Pemphigus vulgaris (PV) is a severe blistering autoimmune-mediated skin disease requiring immune-suppressive therapy. Here, we present a case, wherein a patient with severe PV underwent rituximab therapy, while simultaneously a newly diagnosed advanced cervical carcinoma was treated with pembrolizumab.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"256-261"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530330","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":"Acetaminophen as a possible safer alternative for reducing prostaglandin E2-major urinary metabolites concentrations and alleviating joint pain in pachydermoperiostosis","authors":"Tomoya Takegami,&nbsp;Takashi Nomura,&nbsp;Satoru Yonekura,&nbsp;Akiyoshi Senda,&nbsp;Kazue Yoshida,&nbsp;Atsuhito Seki,&nbsp;Kazuhiko Nakabayashi,&nbsp;Tadakazu Hisamatsu,&nbsp;Hiroki Kitamoto,&nbsp;Shuji Yamamoto,&nbsp;Yusuke Honzawa,&nbsp;Hiroshi Seno,&nbsp;Hironori Niizeki,&nbsp;Kenji Kabashima","doi":"10.1002/jvc2.429","DOIUrl":"https://doi.org/10.1002/jvc2.429","url":null,"abstract":"&lt;p&gt;Pachydermoperiostosis (PDP) is an autosomal recessive hereditary disease that predominantly affects males, characterized by three distinctive diagnostic features: digital clubbing, periostosis, and pachydermia of the face.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Severe pachydermia can lead to ridges and furrows of the scalp, giving rise to a cerebriform appearance termed cutis verticis gyrata (CVG).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; PDP is classified into three subcategories: a complete form presenting the full-blown phenotype, including CVG; an incomplete form with three diagnostic features without CVG; and a forme fruste with pachydermia without or with minimal periostosis.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; PDP arises from prostaglandin E2 (PGE2) excess due to variations in two genes: &lt;i&gt;HPGD&lt;/i&gt; and &lt;i&gt;SLCO2A1&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; The concentration of PGE2-major urinary metabolites (PGE-MUM) reflects that of serum PGE2 and is positively correlated with the severity of &lt;i&gt;SLCO2A1&lt;/i&gt;-mutated PDP.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; PDP patients can be complicated by hyperhidrosis, arthralgia, or chronic enteropathy associated with &lt;i&gt;SLCO2A1&lt;/i&gt; (CEAS).&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Etoricoxib, a selective cyclooxygenase-2 inhibitor (COX-2i), decreases serum PGE2 levels and alleviates pachydermia and arthralgia in PDP patients.&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt; However, COX-2i has been found to induce mucosal injuries in the small intestine of 33% of healthy volunteers, suggesting potential hazards for individuals with &lt;i&gt;SLCO2A1&lt;/i&gt; mutations at risk for CEAS.&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; Here, we report a complete form PDP patient with a history of total colectomy who experienced benefits from acetaminophen.&lt;/p&gt;&lt;p&gt;Our patient, previously reported,&lt;span&gt;&lt;sup&gt;4, 9&lt;/sup&gt;&lt;/span&gt; presented with hyperostosis, digital clubbing, and pachydermia accompanied by CVG (Figure 1). The patient carried compound heterozygous mutations c.940+1 G &gt; A (p.R288Gfs*7) and c.1807C &gt; T (p.R603*) in &lt;i&gt;SLCO2A1&lt;/i&gt;. He developed severe gastrointestinal bleeding and underwent total colectomy at the age of 19. Since the age of 28, he had been suffering from chronic arthralgia. The arthralgia was relieved with oral celecoxib at 400 mg/day, but it was terminated because of stomachache. Alternatively, acetaminophen was initiated at varying dosages ranging from 0 to 2000 mg/day, depending on the severity of arthralgia. Three years later, capsule endoscopy was performed due to stomachache and found obliquely to annular ulcers in the ileum. Possible diagnoses included intestinal tuberculosis, Crohn's disease, intestinal Behcet's disease, drug-induced enteritis, and CEAS. The absence of caseating granuloma, cobblestone appearances, or repeated genital ulcerations suggests less likely the former three diseases, respectively. Drug-induced enteritis was unlikely because resuming the acetaminophen did not reproduce the abdominal pain. Diagnosis of CEAS was suggestive but inconclusive because the colon mucosa w","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"277-280"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.429","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530331","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 international society of atopic dermatitis held a meeting in Gdańsk to discuss the organization of care in atopic dermatitis","authors":"Jean-François Stalder,&nbsp;Peter Lio,&nbsp;Fanny Sentenac,&nbsp;Alain Taieb,&nbsp;Magdalena Trzeciak,&nbsp;Joanna Małaczyńska-Rentfleisz,&nbsp;Ousmane Faye,&nbsp;Fahafahantsoa Rapelanoro Rabenja,&nbsp;Rachel Ogola,&nbsp;Henrique Ishii,&nbsp;Leonardo Faria,&nbsp;Roberto Takaoka","doi":"10.1002/jvc2.548","DOIUrl":"https://doi.org/10.1002/jvc2.548","url":null,"abstract":"&lt;p&gt;A pre-meeting on the Organisation of Care in Atopic Dermatitis was organised on the 31st of August 2023 in Gdańsk under the leadership and guidance of the International Society of Atopic Dermatitis (ISAD), with the objective of breaking new grounds in clinical practice and the organisation of care for patients with atopic dermatitis (AD).&lt;/p&gt;&lt;p&gt;Since 2008, under the leadership of Dr. Roberto TAKAOKA, the ISAD organises pre-meetings dedicated to the Organisation of Care in Atopic Dermatitis and possible collaborations among patients, physicians and other healthcare professionals worldwide. Design thinking and social innovation were also employed to tackle the problem of AD in Africa and Latin America.&lt;/p&gt;&lt;p&gt;Focused on the daily management of atopic patients, the programme explored the specificities of patient care with examples from Poland, Africa, United States and Brazil. This exchange facilitated the gathering of individuals from diverse backgrounds, all connected by their concern for eczema. For the first time, African representatives, both experts and patients, were hosted, having been invited by the World Health Organisation.&lt;/p&gt;&lt;p&gt;The more we familiarise ourselves with different perspectives worldwide, the deeper our insights into the origins and management of this intriguing and captivating disease become.&lt;/p&gt;&lt;p&gt;The chairs of this meeting were Pr Jean-François STALDER and Dr Roberto TAKAOKA.&lt;/p&gt;&lt;p&gt;The recording of this meeting can be watched on the ISAD website.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;&lt;i&gt;Speaker: Dr Magdalena TRZECIAK from the Department of Dermatology, Venereology, and Allergology of Gdansk, Organizer of the ISAD meeting&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;After a brief introduction to the causes and burden of AD, presented the role of stakeholders and the needs of patients regarding therapeutic education, including the roles of online and in-person education.&lt;/p&gt;&lt;p&gt;A variety of doctors manage AD patient care: general practitioners, pediatricians, allergists, and dermatologists. A recent survey indicates that 75% of adult patients feel they haven't received answers to crucial questions about AD, highlighting a significant gap in patient education. They emphasise a lack of information on using local treatments. Patients express a need for information and personalised advice on using emollient therapy and bathing. There is a consistent reluctance among patients to use Topical Corticosteroids (TCS), with 90% delaying their use as long as possible and ceasing their use prematurely, indicating a need for improved education and reassurance about these treatments.&lt;/p&gt;&lt;p&gt;Globally, phobia towards topical treatments is extremely common, leading to patient reluctance and rapid discontinuation of topical corticosteroids and calcineurin inhibitors (TCI). A significant portion of patients with AD (77%) expressed a desire for a mobile application to manage their condition, emphasising itch relief and a “flare-up calendar” to identify trigger factors.&lt;/p&gt;&lt;p&gt;This summa","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"335-344"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530813","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":"Painful nodule on the left fifth finger","authors":"Chihiro Hishinuma,&nbsp;Yuko Watanabe,&nbsp;Hideyuki Ishikawa,&nbsp;Atsuhito Nakazawa,&nbsp;Yukie Yamaguchi","doi":"10.1002/jvc2.583","DOIUrl":"https://doi.org/10.1002/jvc2.583","url":null,"abstract":"&lt;p&gt;A 75-year-old Japanese man had a history of Stage IVb squamous cell lung cancer (cT3N1M1c) with metastases to the right ribs and left adrenal gland. He had previously tested negative for key nonsmall cell lung cancer driver mutations, including epidermal growth factor receptor, anaplastic lymphoma kinase, C-ros oncogene 1, v-raf murine sarcoma viral oncogene homolog B1 and programmed cell death protein 1. He presented with a painful nodule on the distal phalanx of his left fifth finger. The nodule had gradually increased to 3 cm in diameter and had a red, vascular surface (Figure 1). Initially, the nodule was diagnosed as paronychia and treated with antibiotics, but the condition did not improve. Radiography revealed complete destruction of the distal phalanx (Figure 2), and positron emission tomography-computed tomography showed abnormal uptake in the lesion. A biopsy was performed from the lesion on the left fifth finger (Figure 3a,b).&lt;/p&gt;&lt;p&gt;The patient was treated with a combination of pembrolizumab and cytotoxic anticancer agents, including paclitaxel and carboplatin. After starting treatment, the acrometastasis shrank dramatically and almost disappeared within 3 months (Figure 4) and dropped off spontaneously 5 months after treatment initiation. However, the patient's condition deteriorated due to the progression of the primary lung cancer, leading to a transition to palliative care. He passed away 2 weeks later.&lt;/p&gt;&lt;p&gt;Acrometastases refer to secondary lesions located distal to the elbow and knee, accounting for 0.1% of all bone metastases.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; They are often misdiagnosed due to their rarity, with 56.8% of hand or wrist lesions initially mistaken for infections such as abscess, felon, osteomyelitis, paronychia or tuberculosis.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Symptoms typically include redness, swelling, pain and limited movement. Because patients with cancer typically have the primary tumour identified first, acrometastases should be considered in the differential diagnosis of distal lesions in patients with cancer.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; Our patient had a bone metastasis of lung cancer in the distal phalynx, which is the most common site of phalyngeal metastases.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Acrometastases may occur on either the right or left hand, with bilateral metastases being relatively rare.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The primary site in our patient was situated in the middle lobe of the left lung, disseminating to the right ribs and left adrenal gland. Notably, phalangeal metastases exhibit a nonlateralized distribution pattern with no discernible association with the laterality of the primary neoplasm, regardless of whether it is in the lung, breast or kidney.&lt;/p&gt;&lt;p&gt;The pathophysiology of acrometastasis is not fully understood but is believed to involve the hematogenous spread of tumour emboli. Mulvey et al.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; speculated that venous erosion by a pulmonary neoplasm allows tumour emboli to dissem","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"364-367"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.583","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A reply to “Letter to the editor in response to the article ‘To assess the attitudes of Irish patients attending a pigmented lesion clinic and healthcare staff employed in an academic hospital to biobanking, a quantitative study’”","authors":"Stephanie Bowe,&nbsp;Claire Quigley,&nbsp;Liana Victory,&nbsp;Eoin Storan","doi":"10.1002/jvc2.558","DOIUrl":"https://doi.org/10.1002/jvc2.558","url":null,"abstract":"<p>Stephanie Bowe conceived and designed the analysis, collected the data, contributed data or analysis tools, performed the analysis, wrote the paper. Claire Quigley collected data at pigmented lesion clinics via paper forms. Liana Victory collected data at pigmented lesion clinics via paper forms. Eoin Storan supervised the project and edited the final paper.</p><p>The authors declare no conflict of interest.</p><p>All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the MMUH and Mater Private Hospital Dublin Institutional Review Board at a meeting in October 2022, with the project reference number: 1/378/2322.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1716-1717"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.558","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762667","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}