JEADV clinical practice最新文献

{"title":"Iododerma with cryptococcus-like changes","authors":"S. Subhadarshani,&nbsp;L. E. Flowers,&nbsp;C. Logan,&nbsp;K. E. Spicknall,&nbsp;C. Shaughnessy","doi":"10.1002/jvc2.588","DOIUrl":"https://doi.org/10.1002/jvc2.588","url":null,"abstract":"<p>Iododerma is a rare halogenoderma resulting from exposure to iodinated compounds. We present a case involving a 51-year-old Caucasian female with advanced renal disease who developed a hemorrhagic and papulonodular eruption following oral contrast exposure. Cryptococcoid bodies were noted on histopathological evaluation and raised suspicion for the diagnosis of iododerma, which was ultimately confirmed through serum and urine iodine studies. This case highlights a severe presentation of iododerma with important dermatopathology findings.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"269-272"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530636","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":"Vitamin D in patients with psoriasis compared with healthy individuals or with other diseases: A systematic review and meta-analysis","authors":"Bruny Carolina Llamas Castellanos,&nbsp;Wanderley Augusto Arias Ortíz","doi":"10.1002/jvc2.550","DOIUrl":"https://doi.org/10.1002/jvc2.550","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Psoriasis is a chronic skin disorder characterized by the accelerated proliferation of keratinocytes, which leads to the formation of scaly plaques and a chronic inflammatory response. Vitamin D is an inhibitor of dendritic cells acting as an immune modulator; therefore, vitamin D deficiency could explain the increased incidence of psoriasis for the reduction of anti-inflammatory activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare serum 25-hydroxy vitamin D levels in patients with psoriasis and healthy individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review of the literature and meta-analysis was performed by searching PubMed, Embase, Cochrane, Lilacs, Ovid and ProQuest databases to find the best available evidence from 2013 to 2024. We also conducted a snowballing literature search to expand the included studies. The methodological quality and risk of bias were assessed through the Newcastle–Ottawa scale. A random effect meta-analysis model was applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 27 articles were included in the systematic review of these three cross-sectional studies included in the first meta-analysis, the synthesized standardized mean difference (SMD) in serum vitamin D between psoriatic arthritis and psoriasis was −0.13 (95% CI [−0.46, 0.20], <i>p</i> = 0.45). The second meta-analysis included two case controls, the synthesized SMD in serum vitamin D between psoriasis and controls was −0.71 (95% CI [−0.85, −0.57], <i>p</i> = 0.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>No difference in vitamin D levels between psoriasis and psoriatic arthritis was found. Psoriasis patients have lower vitamin D levels than the general population. However, further studies are essential to understand how vitamin D levels contribute to the pathogenesis of psoriasis or vice versa and its role in severity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"49-60"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530743","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":"Multiple keratotic papulonodular lesions in a human immunodeficiency virus-negative patient","authors":"Rawan Almutairi,&nbsp;Khaled Alobaid,&nbsp;Humoud Al-Sabah,&nbsp;Ahmed Attia,&nbsp;Atlal Allafi","doi":"10.1002/jvc2.578","DOIUrl":"https://doi.org/10.1002/jvc2.578","url":null,"abstract":"&lt;p&gt;A 52-year-old Bangladeshi female patient presented to the dermatology clinic, in Kuwait, with a painful ulcer and two skin abscesses on her neck accompanied by multiple keratotic papulonodular lesions located in the right mandibular area of her face. The lesions had appeared 3 weeks before, and had gradually increased in size. The patient also mentioned loss of weight, 4 kg in 2 months, with loss of appetite. She did not complain of night sweats, but had a chronic cough with clear sputum. Her medical history revealed that she was diagnosed with haemoglobin E trait since childhood. She had been infected with pulmonary tuberculosis in Bangladesh 25 years ago.&lt;/p&gt;&lt;p&gt;The patient's vital signs were normal except for elevated temperature (37.3°C). Skin examination revealed a unilateral right mandibular distribution of keratotic papulonodular skin lesions, some of which coalesced to form plaques. These lesions also involved the pre- and postauricular areas. One ulcer measuring 1.5 × 2 cm and two skin abscesses were present in the right lateral neck (Figure 1). No other skin lesions were seen in the other parts of the body. Multiple tender cervical lymph nodes were also observed. Abdominal examination revealed hepatomegaly. The rest of systemic examination was otherwise normal.&lt;/p&gt;&lt;p&gt;Laboratory investigations revealed mild anaemia (haemoglobin = 10.2), eosinophilia, and an elevated erythrocyte sedimentation rate. HbA1C level is 5.7%. Repeated HIV test was negative. Acid-fast bacillus staining and culture from sputum specimen were negative. The chest radiograph was unremarkable. A high-resolution CT chest showed atelectatic bands in the right upper lobe. Tissue culture for tuberculosis was negative. Extractable nuclear antigen panel was negative for autoantibodies. A skin biopsy was taken (Figure 2).&lt;/p&gt;&lt;p&gt;Histoplasmosis is an infection caused by the fungus &lt;i&gt;H. capsulatum&lt;/i&gt;, which is present in contaminated soil and materials containing bat and bird waste. Histoplasmosis is rare in immunocompetent individuals, and is rarely reported in Kuwait.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Histoplasmosis is classified in four types according to its clinical manifestations: asymptomatic (95%), acute pulmonary, chronic pulmonary, and disseminated.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Disseminated histoplasmosis particularly affects the reticulohistiocytic system. The liver, spleen, pancreas, and intestines, are often affected. Hence, patients with disseminated histoplasmosis may exhibit a range of clinical manifestations, including fever, anorexia, weight loss, cough, vomiting, diarrhoea, abdominal pain, and hepatosplenomegaly.&lt;/p&gt;&lt;p&gt;Up to 17% of patients with disseminated histoplasmosis develop cutaneous lesions that are diverse and nonspecific and are caused either by the fungus, which causes papules, plaques, nodules, or ulceration, or by an immune response to the infection, such as erythema nodosum or erythema multiforme.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The face, trunk, and extremities ","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"359-363"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530744","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":"Pustules in a 59-year-old Hispanic man","authors":"Judith M. Corona-Herrera,&nbsp;Betzabé Quiles-Martínez,&nbsp;Fanny C. López-Jiménez,&nbsp;Rebeca Palafox-Romo,&nbsp;Saeb-Lima Marcela,&nbsp;Salazar H. Amparo,&nbsp;Silvia Méndez-Flores","doi":"10.1002/jvc2.585","DOIUrl":"https://doi.org/10.1002/jvc2.585","url":null,"abstract":"&lt;p&gt;A 59-year-old Hispanic man was attended at the Dermatology department with a widespread cutaneous eruption affecting all body areas. The patient reported no allergies, medication use, or history of autoimmune diseases, celiac disease, or recurrent tonsillitis. This skin condition developed after abruptly stopping a 60 mg prednisone regimen. The eruption was characterized by numerous pustules, some with a distinctive “half and half” appearance. Pustules coalesced into areas of superficial erosions, predominantly in flexural areas (Figures 1 and 2). The lesions exhibited a centrifugal spread, with pustules and erosions at the periphery and postinflammatory macules in the center. Upon resolution, the lesions left adherent fine scaling, areas of hyperpigmentation, and crusting. Histopathology findings are shown in Figures 3 and 4. Laboratory tests at the time showed normal results for complete blood count and blood chemistry, except for low levels of 25-hydroxyvitamin D (normal range: 30–100 ng/mL). A pustule was cultured, with negative result.&lt;/p&gt;&lt;p&gt;The pustules in our patient's eruption showed the “hypopyon sign,” which is characterized by the presence of small vesicles initially filled with clear fluid, that subsequently become turbid due to neutrophil infiltration, resulting in pus accumulation at the base of the vesicle when the patient is upright.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;GPP is a rare, chronic, and severe inflammatory skin disorder characterized by sudden outbreaks of sterile pustules, often accompanied by systemic inflammation.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The diagnosis of GPP can be challenging due to its rarity (see Table 1 for differential diagnoses), and requires an accurate clinicopathological correlation. Histopathological findings may demonstrate slight acantholysis, classified as secondary because it follows keratinocytic injury rather than being caused strictly by desmosome damage.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Although our main differential diagnosis were IgA pemphigus or its variants, a negative immunofluorescence would exclude them, considering direct immunofluorescence is reported to be positive in nearly all cases of IgA pemphigus.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; In fact, a meta-analysis found that IgA deposits were identified in 97% of the cases.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In GPP, hyperactivation of the innate immune system, particularly the IL-36 axis, is predominant. An uncontrolled signalling and proinflammatory cytokine overproduction occurs either through overexpression of IL-36 agonists or by the expression of a dysfunctional IL-36R antagonist, leading to attraction of neutrophils to the epidermis, manifesting clinically as pustules.&lt;span&gt;&lt;sup&gt;2, 6&lt;/sup&gt;&lt;/span&gt; Genetic studies have found pathogenic variations and mutations of &lt;i&gt;IL36RN, CARD14, AP1S3, MPO&lt;/i&gt;, and &lt;i&gt;SERPINA3&lt;/i&gt; genes in patients with GPP.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Topical treatments are generally discouraged in GPP due to potential irritation, with sy","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"616-620"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191203","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":"AI powered detection and assessment of onychomycosis: A spotlight on yellow and deep learning","authors":"C. Agostini,&nbsp;R. Ranjan,&nbsp;M. Molnarova,&nbsp;A. Hadzic,&nbsp;O. Kubesch,&nbsp;V. Schnidar,&nbsp;H. Schnidar","doi":"10.1002/jvc2.577","DOIUrl":"https://doi.org/10.1002/jvc2.577","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite significant advances in computer-aided diagnostics, onychomycosis, a widespread fungal nail infection, lacks an automated approach for objective analysis and classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Our study aimed to develop and validate automated machine learning models to accurately detect and classify onychomycosis-affected areas in toenails.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The images in this study were captured using the Scarletred® Vision mobile App and SkinPatch, a CE certified medical device system working seamlessly together to deliver auto-color calibrated, high-resolution clinical images. Considering a total of 1687 images from 440 subjects, the research explores various degrees of onychomycosis and evaluates the infection extent in the toenails detected. We developed an advanced machine learning algorithm for precise segmentation and classification of onychomycosis-affected toenails, utilizing expert annotations and advanced post-processing techniques. Additionally, an analysis of nail growth was performed, and a comparison graph with the percentage of infection was estimated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using advanced machine learning algorithms, we successfully detected toenails, enabling detailed analysis of intricate structures within the images. We achieved a final validation loss of 0.0236 and an F1 score of 0.8566 for accurate toenail detection, while the Random Forest algorithm demonstrated 81% accuracy in classifying and distinguishing between infected and healthy toenail areas. Our applied superpixel method furthermore improved the algorithm's precision in identifying the infected regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our AI-powered image analysis method, initially focused on the big toe's toenail, shows great promise for broader validation on comprehensive datasets, enabling more detailed assessments of onychomycosis severity and disease dynamics. The potential impact of limited patient diversity, particularly with darker skin tones, needs further assessment. Proven to measure nail growth and assess treatment effectiveness over time, our developed AI is the first of its kind to demonstrate this capability, representing a significant advancement as a novel decision support tool for clinical research and routine medical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"156-165"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530567","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":"Immunocryosurgery for facial, non-superficial basal cell carcinoma triggers consistent but transient cell counts alterations in the circulating innate immune cell lines","authors":"G. Gaitanis,&nbsp;A. Ganiatsa,&nbsp;G. Vartholomatos,&nbsp;K. Seretis,&nbsp;I. D. Bassukas","doi":"10.1002/jvc2.573","DOIUrl":"https://doi.org/10.1002/jvc2.573","url":null,"abstract":"&lt;p&gt;Immunocryosurgery, a fixed-time combination of imiquimod and cryosurgery,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; is a highly effective modality for basal cell carcinomas (BCCs),&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; including non-superficial tumors amenable to excision.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Previous studies, both in tissue and peripheral blood, have focused on the role of T-regulatory lymphocytes as antitumor effectors during immunocryosurgery for BCC.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; In the present study we addressed the influence of an immunocryosurgery treatment cycle for BCC on the peripheral blood cell counts.&lt;/p&gt;&lt;p&gt;Institutional Review Committee approval was granted (Θ59 45/17-11-2022). Immunocryosurgery entails the application of 5% imiquimod cream once daily for 5 weeks and a single cryosurgery session on Day 14 of the treatment cycle (liquid N&lt;sub&gt;2&lt;/sub&gt;, open spray, two freeze-thaw cycles of 20 s freezing time each).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; As previously,&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; peripheral blood cell counts were determined at four time points: within 4 days before the initiation of treatment (“Week 0,” ‘baseline’), on the day of cryosurgery (“Week 2”), on the last day (plus a maximum of 2 days) of treatment (“Week 5”), and at 4 weeks follow up (±2 days: “Week 9”). The distributions of continuous variables are represented as medians and means±standard deviations (SD). Friedman tests (four measurements/patient) with &lt;i&gt;post-hoc&lt;/i&gt; Dunn's tests were calculated using SPSS, with &lt;i&gt;p&lt;/i&gt; &lt; 0.05 indicating statistical significance.&lt;/p&gt;&lt;p&gt;Thirteen immunocompetent patients were included (age: 67–81 years; 11 men), each with a facial, biopsy confirmed non-superficial BCC (median BCC diameter: 15 mm, range: 7–19 mm). All tumors responded with vivid local inflammatory alterations, cleared completely after one treatment cycle and remained recurrence-free for at least 12 months. A discrete pattern of temporal variation was encountered in the counts of all leukocyte cell lines, except for monocytes, during imiquimod treatment (Table 1). The whole leukocytes and the three granulocyte subpopulations (neutrophils, eosinophils, and basophils) cell counts reduced significantly compared to baseline during imiquimod application (&lt;i&gt;p&lt;/i&gt; &lt; 0.0001, Friedman test) and recovered within 1 month thereafter. Also, for lymphocytes, nadir counts were observed at the end of imiquimod treatment; however, the perturbations of the lymphocyte numbers did not present a similar deviation degree as the cell lines of the innate immunity (&lt;i&gt;p&lt;/i&gt; = 0.0153, Friedman test). Nonetheless, in no case did the cell numbers at nadir drop below the corresponding normal cell counts limits (Figure 1) or did we observe any clinical signs of immunosuppression.&lt;/p&gt;&lt;p&gt;Our results document a systemic, to date underrecognized immunocryosurgery effect on the peripheral blood cell counts. Thereby the role of imiquimod is central as the counts drop was evident before cryosurgery. Our findings add to the spar","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"316-319"},"PeriodicalIF":0.0,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.573","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530612","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 rapidly growing breast tumour in a young woman","authors":"K. A. Zub Carlsson,&nbsp;S. Spetalen,&nbsp;K. M. A. S. Endre,&nbsp;T. O. A. Hegna,&nbsp;G. E. Tjønnfjord,&nbsp;G. Lehne,&nbsp;Ø. Sandanger","doi":"10.1002/jvc2.584","DOIUrl":"https://doi.org/10.1002/jvc2.584","url":null,"abstract":"&lt;p&gt;A 31-year-old, otherwise healthy Caucasian woman presented with an 8-year history of a generalised pruritic rash only partially responding to topical steroids. Initial skin biopsies showed chronic inflammation with microabscesses, suggesting psoriasiform dermatitis along with epidermal hyperplasia, spongiosis, and chronic infiltrate with neutrophils indicating eczema. In February 2022, the rash on her right breast thickened, and by summertime, it began to ulcerate. By September 2022, the rapid progression of ulcerative lesions raised suspicion of advanced mammary Paget's disease (MPD) or soft tissue sarcoma. However, coarse needle biopsies revealed only granulomatous inflammatory changes, while MR mammography showed thickened tumorous skin tissue with oedema, and pathologically changed lymph nodes in the right axilla. Neither contrast-enhanced CT nor skeletal scintigraphy showed any sign of metastases. Dermatological examination in October 2022 revealed around 50% skin involvement, mainly annular patches, plaques and erosive tumours (Figure 1a). The right breast presented as an extensive ulcerating tumour with exudate (Figure 1b). Skin biopsies from the breast (Figure 2) and other lesions were performed in late September and mid-October 2022, respectively.&lt;/p&gt;&lt;p&gt;Skin biopsies confirmed folliculotropic and epidermotropic MF with Pautrier microabscesses (Figure 2) and numerous CD3 staining intraepidermal lymphocytes. Flow cytometry of peripheral blood and a bone marrow biopsy were unremarkable. The enlarged lymph node in the right axilla exhibited conserved architecture. However, the same monoclonal T-cell receptor gene rearrangement was found in both skin lesions and in the lymph node. Hence, her MF was classified as T3N1aM0B0/stage IIB.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Initial treatment entailed topical 0.05% clobetasol, radiotherapy with electron beams (8 Gy) to selected skin lesions, photon beams (24 Gy) to the involved breast, and bexarotene 450 mg once daily. The irradiated breast tumour tissue underwent necrosis, precipitating systemic Pseudomonas infection, which was treated with meropenem, gradual surgical debridement, and daily dressings containing 10% povidone iodine for 10 days (Figure 3). Urinary iodine concentration on day 10 exceeded the corresponding tolerable upper intake level (UL) by 47-fold, yet typical symptoms of high iodine uptake were absent. Iodine levels fell below UL within 5 weeks after cessation, and subsequent thyroid ultrasound demonstrated normal morphology. Observed transient secondary hypothyroidism was attributed to bexarotene treatment.&lt;/p&gt;&lt;p&gt;Bexarotene exhibited limited response and was replaced by interferon alpha 2-a therapy (180 µg/10 days) after 4 weeks, resulting in significant improvement. Six months after diagnosis, the patient's skin was almost clear of MF lesions (Figure 4). Subsequently, a matched related allogeneic stem cell transplantation (allo-SCT) was pursued for a potential cure.&lt;span&gt;&lt;sup&gt;2&lt;/su","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 2","pages":"612-615"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.584","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190749","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":"Efficacy of brodalumab in psoriasis patients with a body weight >100 kg: Real-world evidence (RWE) from the LIBERO study","authors":"Ralph von Kiedrowski,&nbsp;Khusru Asadullah,&nbsp;Bernhard Korge,&nbsp;Konstantina Tsarovina,&nbsp;Matthias Augustin","doi":"10.1002/jvc2.556","DOIUrl":"https://doi.org/10.1002/jvc2.556","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with psoriasis often suffer from obesity. However, only limited data are available on the efficacy of brodalumab 210 mg, a fully human monoclonal immunoglobulin IgG2 antibody binding to the human interleukin 17 receptor subunit A, in obese patients in daily practice, to date.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>A subgroup analysis from the LIBERO study was conducted to compare the effectiveness of brodalumab in patients weighing ≤100 and &gt;100 kg after ~12 weeks (W) and ~52 W.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>LIBERO is a large prospective, multicenter, non-interventional, real-world-evidence study including adult patients with plaque psoriasis treated with brodalumab 210 mg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four hundred and sixty-one patients with a body weight up to 100 kg (nonobese) and 161 patients with &gt;100 kg body weight (obese) were included in this subgroup analysis. At baseline, the majority of patients in both groups had very severe (12.6%; 15.7%) or severe (49.4%; 55.0%) psoriasis, as assessed by Physician Global Assessment (PGA). As of W2, a significant reduction of the mean PASI could be achieved in both groups. In patients weighing ≤100 kg mean PASI decreased from 16.9 to 9.0 and further improved to 2.6 at ~W12 (<i>p</i> &lt; 0.001). In the patient group &gt;100 kg, the PASI decreased from 17.9 to 10.2 at ~W2 (<i>p</i> &lt; 0.001) and improved further to 3.9 at ~W12 (<i>p</i> &lt; 0.001). However, at ~W12 absolute PASI0-3 rates were lower in patients &gt;100 kg than in patients ≤100 kg (68.4% vs. 80.5%, <i>p</i> = 0.006); there was no statistically significant difference between the groups at ~W52/last visit any more in any of the effectiveness parameters with, for example, a PGA0/1 response of 82.3% versus 86.5% (<i>p</i> = 0.6089), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This subgroup analysis of LIBERO confirmed, that in daily practice brodalumab can be equally beneficial patients with &gt;100 and ≤100 kg in the long-term management of psoriasis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"195-202"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.556","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530799","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 role of wearable technology in real-time skin health monitoring","authors":"Kelly Frasier,&nbsp;Vivian Li,&nbsp;Michelle Sobotka,&nbsp;Julia Vinagolu-Baur,&nbsp;Grace Herrick","doi":"10.1002/jvc2.587","DOIUrl":"https://doi.org/10.1002/jvc2.587","url":null,"abstract":"<p>The integration of wearable technology in real-time skin health monitoring represents a significant advancement in personalised healthcare. This review synthesises existing research on wearable devices tailored for skin condition monitoring, encompassing aspects such as ultraviolet exposure tracking, hydration level assessment, and early detection of potential dermatological diseases. Current literature underscores the efficacy of wearable sensors in providing timely insights into skin health parameters, enabling proactive skin care interventions and disease management. Moreover, the seamless integration of sensor data with smartphone applications facilitates user-friendly monitoring and personalised alerts, enhancing user engagement and adherence to skincare regimens. Moving forward, future research should prioritise the refinement of sensor accuracy and reliability, the development of standardised metrics for skin health assessment, and the exploration of novel applications such as artificial intelligence-driven predictive analytics for early disease detection. Additionally, interdisciplinary collaborations between engineers, dermatologists, and data scientists hold promise for unlocking the full potential of wearable technology in revolutionising skin health management. Incorporating wearable technology in real-time skin health monitoring not only revolutionises preventive skincare practices but also holds immense potential for transforming the management of chronic skin conditions, paving the way for personalised, proactive, and patient-centric dermatological care.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530663","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":"Mechanobullous form of epidermolysis bullosa acquisita: Insights into disease mechanisms as inferred by response to rituximab, but not to JAK inhibitors","authors":"L. Gueissaz,&nbsp;A. Junge,&nbsp;R. Wolf,&nbsp;C. Schlapbach,&nbsp;L. Feldmeyer,&nbsp;L. Borradori","doi":"10.1002/jvc2.568","DOIUrl":"https://doi.org/10.1002/jvc2.568","url":null,"abstract":"<p>Epidermolysis bullosa acquisita (EBA) is a rare autoimmune blistering disease associated with IgG autoantibodies directed against type VII collagen. Different clinical forms have been described, including the classical mechanobullous variant resembling epidermolysis bullosa dystrophica, which is typically treatment-resistant. We here describe a 67-year-old patient with a mechanobullous EBA characterized by trauma-induced blisters on her hands and feet for 9 months. Despite treatments with oral prednisolone, topical steroids or calcineurin inhibitors, doxycycline, ciclosporin, and baracitinib, no improvement was observed. The patient went into complete remission only after administration of rituximab with no lesions off therapy at the 10-month follow up. Our observation suggests that inflammatory cytokines are not primarily responsible for skin blistering and fragility in mechanobullous EBA. The effectiveness of rituximab provides some insights into the major direct role of autoantibodies in mediating dermo-epidermal separation in this variant of EBA.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"253-255"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.568","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530666","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}