JEADV clinical practice最新文献

{"title":"Assessment of inflammatory bowel disease risk prior to commencing IL-17 inhibitors: A cross sectional analysis of Irish practice","authors":"Amy Long, Claire Quigley, Lisa Murphy, Susan O'Gorman","doi":"10.1002/jvc2.579","DOIUrl":"https://doi.org/10.1002/jvc2.579","url":null,"abstract":"<p>Dermatologists are well-acquainted with the transformative impact of biologics in managing chronic skin conditions such as psoriasis and hidradenitis suppurativa (HS). This success is mirrored in the field of rheumatology. Interleukin (IL)-17, a proinflammatory cytokine, plays a crucial role in host defence but paradoxically can contribute to the pathogenesis of inflammatory diseases. IL-17 inhibition has been linked to the unmasking or exacerbation of inflammatory bowel disease (IBD) in some patients.<span><sup>1</sup></span> Despite this, there are currently no guidelines for IBD screening before initiating IL-17 inhibitors.</p><p>This study aimed to evaluate current practices among Irish dermatologists and rheumatologists in assessing IBD risk before commencing IL-17-targeted treatments. An anonymous survey was disseminated to members of the Irish Association of Dermatologists and the Irish Society of Rheumatology in March 2024.</p><p>Sixty-five consultants and registrars responded (68% dermatology, 32% rheumatology), with 54% at consultant level. A significant majority (97%) were aware of an association between Il-17 inhibitors and IBD unmasking (Figure 1). Routine assessment for IBD risk before initiating IL-17 therapy was performed by 87% of dermatologists and 76% of rheumatologists. Faecal calprotectin measurements were used routinely by 8% of clinicians (11% dermatology, 0% rheumatology), but were more frequently considered when patients had gastrointestinal (GI) symptoms or positive family history, with 73% of clinicians (92% dermatology, 76% rheumatology) opting for the test in these cases. At follow-up, 57% of respondents in both specialties were assessed for GI symptoms in patients on IL-17 inhibitors.</p><p>In the absence of formal screening protocols, this survey offers valuable insights into current practices, highlighting the variability in how Irish clinicians assess IBD risk before and during IL-17 inhibitor treatment. Faecal calprotectin, a simple and inexpensive test (€7–€20 in Ireland), has high sensitivity and specificity for detecting IBD in patients with GI symptoms, but its role in asymptomatic patients remains undetermined. Our survey found that faecal calprotectin was primarily used in patients with GI symptoms or risk factors, rather than as a universal screening tool, which may be appropriate given the low risk of developing IBD with anti-IL-17 therapy. A thorough risk-benefit analysis could help determine whether universal or targeted screening based on risk factors is necessary and cost-effective. Generally, a faecal calprotectin level above 200 µg/g is indicative of bowel pathology, while values below 50 µg/g are considered negative, though no specific concentration can definitively rule out IBD.<span><sup>2</sup></span> Additional research is needed to determine the thresholds at which IL-17 inhibitors are considered safe. There was discordance in how consistently symptom screening was applied, despite widespre","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"308-310"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.579","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530423","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":"What lies beneath: A qualitative review of misinformation on vulval lichen sclerosus","authors":"Yixuan Goh,&nbsp;Cathal O'Connor,&nbsp;Michelle Murphy","doi":"10.1002/jvc2.561","DOIUrl":"https://doi.org/10.1002/jvc2.561","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lichen sclerosus (LS) is a chronic inflammatory skin condition that most commonly affects the vulva and can significantly affect quality of life. While websites and social media can offer helpful information, there is little known about the content of misinformation on LS online.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to qualitatively assess the content of misinformation surrounding vulval LS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed misinformation related to LS on the internet through a search on PubMed, Google and various social media platforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The key themes of misinformation included incorrect causes of LS such as gut dysbiosis and infections; fake ‘cures’ for LS such as elimination diets, homeopathic remedies, Borax, or unproven ‘ground-breaking’ procedures like lasers and plasma-rich protein injections; and criticism of topical corticosteroids and exaggeration of potential side-effects, despite corticosteroids being the gold-standard treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Dermatologists, gynecologists and general practitioners should be aware of these misleading claims, be prepared to refute them, and steer patients to reliable sources of information and evidence based therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"352-355"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.561","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530483","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":"Acquired reactive perforating dermatosis within poikiloderma of Civatte elicited by narrow-band UVB therapy for psoriasis","authors":"G. Gaitanis,&nbsp;L. Feldmeyer,&nbsp;R. Wolf","doi":"10.1002/jvc2.567","DOIUrl":"https://doi.org/10.1002/jvc2.567","url":null,"abstract":"&lt;p&gt;Primary perforating dermatosis group of skin diseases encompasses &lt;i&gt;hyperkeratosis follicularis et parafollicularis in cutem penetrans&lt;/i&gt; (Kyrle's diseases), &lt;i&gt;elastosis perforans serpiginosa&lt;/i&gt; and &lt;i&gt;reactive perforating dermatoses&lt;/i&gt; (syn. &lt;i&gt;collagenosis&lt;/i&gt;) with hereditary and acquired forms.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Histopathologically are characterized by the elimination of collagen or elastin fibers through the epidermis.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;A 64-year Caucasian female with a Fitzpatrick type III skin type received treatment for an acute onset of guttate psoriasis with 311 nm NB-UVB therapy (Medisun 2800, Schulze &amp; Bohm, Germany) three times per week and topical betamethasone/calcipotriol foam once daily. She reported phototherapy treatment for psoriasis twenty years earlier. Her medical history was otherwise unremarkable.&lt;/p&gt;&lt;p&gt;After nine sessions of NB-UVB therapy (cumulative dose 5800 mJ/cm&lt;sup&gt;2&lt;/sup&gt;) the psoriatic lesions were remitting (Figure 1a). Yet, multiple intensely itchy partly coalescing crusted papulopustules up to 7 mm diameter with a keratotic center appeared on poikilodermatous background covering the V-area and the intermammary cleft (Figure 1b). Subsequently, the affected area was light-protected during UV irradiations and fusidic acid 2% cream was applied twice daily under the provisional diagnosis of staphylococcal impetigo. Bacterial swab results were negative while the concurrent laboratory work up showed only hyperlipidemia without diabetes or impaired renal function. A lesional skin biopsy from the V-area revealed a cup-shaped epidermal erosion filled with a basophilic plug of keratin, inflammatory debris, and expelled collagen and elastic fibers, findings compatible with ARPD (Figure 2). The differential diagnosis also included erosions secondary to the intense itching, yet ARPD is typical characterized by a dense central keratotic plaque rich of debris and expelled dermal fibers as seen here. The PAS stain showed a missing basement membrane (BM) at the site of the erosion without any hyphae, spores or gram-positive bacteria.&lt;/p&gt;&lt;p&gt;The constellation of the clinical, laboratory and pathology findings support the diagnosis of an ARPD associated with guttate psoriasis on a chronic solar poikiloderma background (Civatte). Four weeks later the symptoms and clinical signs for both the ARPD and psoriasis had subsided (Figure 1c) and the patient opted to discontinue all therapeutic interventions.&lt;/p&gt;&lt;p&gt;ARPD arose unexpectedly within a psoriatic background, a combination that has been sparsely reported in literature. Actually, a PubMed search (23 September 2024) up to 1980 under the terms ‘perforating dermatosis’ OR ‘perforating collagenosis’ AND ‘psoriasis’ returned 32 articles in which only three patients are reported with the combination of ARPD and psoriasis.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; Two of the patients were of dark skin phototype (Philipino and Indian)&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; with one ","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"304-307"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530419","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":"Clinical spectrum of indolent mycosis fungoides with a gamma-delta (γδ) phenotype: a single institution review including therapy and outcomes","authors":"N. A. Ufkes,&nbsp;R. Tao,&nbsp;A. S. Halwani,&nbsp;R. Miles,&nbsp;S. D. Cipriano,&nbsp;M. Bowling,&nbsp;S. Florell,&nbsp;D. Gaffney,&nbsp;D. A. Wada","doi":"10.1002/jvc2.562","DOIUrl":"https://doi.org/10.1002/jvc2.562","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Primary cutaneous γδ T-cell lymphoma (CGD-CTL) is a rare malignancy that classically exhibits an aggressive clinical phenotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Review cases of mycosis fungoides with a γδ phenotype that demonstrated an indolent clinical course.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective review of patients diagnosed with MF with a γδ phenotype and an indolent clinical course between 2018 and 2022 treated at the University of Utah.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five patients ages 4-81 years old were identified. All presented with clinically persistent patch or plaque-stage disease, and histopathology showed primarily epidermotropic infiltrates positive for TCR delta via immunostaining. None of these patients have required aggressive treatment with multiagent chemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There exists a subset of indolent CGD-TCL patients who are clinicopathologically distinct from classic CGD-CTL and clinically resembling indolent MF. Therefore, we prefer the term “MF with γδ phenotype” for these rare cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"203-206"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530746","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 cross-sectional study on quality of life in adult indolent systemic mastocytosis and its association with cutaneous involvement","authors":"Eugenio Isoletta,&nbsp;Annalisa De Silvestri,&nbsp;Alice Bonelli,&nbsp;Michele Di Stefano,&nbsp;Elisa Bono,&nbsp;Jacqueline Ferrari,&nbsp;Chiara Elena,&nbsp;Valeria Brazzelli","doi":"10.1002/jvc2.553","DOIUrl":"https://doi.org/10.1002/jvc2.553","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Systemic mastocytosis (SM) is characterized by abnormal mast cell accumulation in various tissues, including the skin, and encompasses several clinical variants, ranging from less aggressive to more severe forms. ISM, the most common variant, often presents with cutaneous manifestations, causing significant impairment in QoL due to mediator-release symptoms and stigma associated with typical cutaneous lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The study aimed to assess QoL impairment in ISM patients and its correlation with demographic and clinical data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of 52 adult ISM patients was evaluated using the Dermatology Life Quality Index (DLQI) and the mastocytosis QoL questionnaire (MC-QoL). Questionnaire scores were then analyzed in relation to the clinical and demographic characteristics of the patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over half of the patients experienced mild or higher levels of impairment in QoL, with female patients showing greater impairment than males. Patients with recent symptom onset reported higher MC-QoL scores, possibly due to psychological factors and lack of disease knowledge. Cutaneous symptoms significantly impacted QoL, and the visibility of lesions affected DLQI scores more than MC-QoL scores. A moderately strong correlation was observed between DLQI and MC-QoL scores, particularly in the Skin and Social Life domains. The study highlights gender differences in QoL impairment, suggesting the need for further investigation into potential social or cultural factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While the study provides valuable insights into QoL impairment in ISM patients, its monocentric nature and small sample size are notable limitations. Further research is warranted to better understand the impact of SM on patients' well-being and to identify effective strategies for managing symptoms and improving overall QoL in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"345-351"},"PeriodicalIF":0.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530595","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":"Update on the treatment of BRAFmut metastatic melanoma and future perspectives","authors":"Peter Mohr,&nbsp;Inès Nakouri,&nbsp;Sylvie Pfersch,&nbsp;François Denjean,&nbsp;Celeste Lebbé","doi":"10.1002/jvc2.544","DOIUrl":"https://doi.org/10.1002/jvc2.544","url":null,"abstract":"<p>v-Raf murine sarcoma viral oncogene homolog B (<i>BRAF</i>) mutations were first identified in melanoma in 2002, leading to increased cell division and proliferation, and resultant tumour growth. The identification and characterisation of <i>BRAF</i> mutations (<i>BRAF</i>mut) led to the development of several highly specific, BRAF-, then mitogen-activated kinase enzyme (MEK)-targeted therapies that have enabled rapid tumour responses and improved treatment outcomes in most patients with metastatic <i>BRAF</i>mut melanoma. The combination of these two drug classes (BRAF inhibitors and MEK inhibitors) has demonstrated improved response rates, progression-free survival, and overall survival (OS), along with a more tolerable safety profile, compared with BRAF inhibition alone. In parallel, improved knowledge of the immune system has enabled the development of immune checkpoint inhibitors (ICIs), although immune-related adverse events with ICIs may prove to be problematic in some patients and require careful management. While targeted therapy appears to provide rapid disease control in a relatively high proportion of patients, the development of secondary resistance may limit the overall duration of responses. Acquired resistance, along with primary resistance, has also been reported for ICIs, with a lower overall response rate to that with targeted therapy, although durable responses have been reported in some responding patients. A combination strategy of targeted therapy with ICIs has demonstrated modest increases in efficacy compared with targeted therapy combinations, although data significance varies across studies, there is increased risk of toxicity, and triple combination therapy has not yet received clinical approval in Europe. Thus, there is an ongoing need to establish optimal sequencing of these treatments in patients with advanced <i>BRAF</i>mut melanoma, and this has become the focus of current research. The aim of this narrative review was to provide an update on the treatment of <i>BRAF</i>mut metastatic melanoma, current guideline recommendations, and future clinical perspectives.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"30-41"},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530767","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":"Prescribing patterns amongst UK dermatologists for the treatment of alopecia areata, female pattern hair loss, and frontal fibrosing alopecia","authors":"John Frewen,&nbsp;Dalia Alsaadi,&nbsp;Leila Asfour,&nbsp;Sharon Belmo,&nbsp;Alyson Bryden,&nbsp;Caroline Champagne,&nbsp;Nicola Clayton,&nbsp;Nicola Cooke,&nbsp;Donna M. Cummins,&nbsp;David Fairhurst,&nbsp;Paul Farrant,&nbsp;Gordan Hale,&nbsp;Susan Holmes,&nbsp;Thomas Harries,&nbsp;Ruth Jones,&nbsp;Sanja Karanovic,&nbsp;Manjit R. Kaur,&nbsp;Nekma Meah,&nbsp;Megan Mowbray,&nbsp;Archana Rao,&nbsp;Nasim Rouhani,&nbsp;Nicola Salmon,&nbsp;Anita Takwale,&nbsp;Martin Wade,&nbsp;Sharon Wong,&nbsp;Shirin Zaheri,&nbsp;Yusur Al-Nuaimi,&nbsp;Matthew Harries","doi":"10.1002/jvc2.495","DOIUrl":"https://doi.org/10.1002/jvc2.495","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Therapeutic management of hair loss is frequently complicated by a lack of high-quality evidence and reliant on the use of unlicensed therapies. Treatment decision-making is predominantly based on expert opinion, local availability, personal experience, and cost, which make informed choices challenging for clinicians and patients in this area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aims were to determine prescribing patterns amongst UK Dermatologists with a special interest in hair disorders, when treating mild-moderate alopecia areata (AA), severe AA (including alopecia totalis/alopecia universalis), female pattern hair loss (FPHL) and frontal fibrosing alopecia (FFA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consultant members of the British Hair and Nail society, a special interest group affiliated to the British Association of Dermatologists, were invited to participate from across the United Kingdom. Participants were questioned on their current prescribing patterns in both NHS and private practice, were asked to rank their first-to-fifth line treatments for each condition and highlight the treatment they perceive as most effective for each disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six Consultant Dermatologists completed the questionnaire, from twenty-three institutions. For treatment of mild-moderate AA, topical corticosteroids were used first line amongst 65% (<i>n</i> = 17) of respondents, and 82% (<i>n</i> = 23) reported that intralesional corticosteroids were the most effective treatment. For severe AA, oral corticosteroids were used first line amongst 38% (<i>n</i> = 10) of respondents, and 25% (<i>n</i> = 8) reported that oral corticosteroids were the most effective treatment. For FPHL, topical minoxidil was used first line amongst 84% (<i>n</i> = 25) of respondents, and 42% (<i>n</i> = 10) reported that oral minoxidil was the most effective treatment. For FFA, topical corticosteroids were used first line amongst 62% (<i>n</i> = 16) of respondents, and 37% (<i>n</i> = 14) reported that hydroxychloroquine was the most effective treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study reports real-world prescribing practices amongst dermatologists treating common hair loss conditions. These results aim to support clinicians with decision making for managing hair loss conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"72-81"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530719","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":"Eosinophilic pustular folliculitis associated with IgA deficiency","authors":"L. E. Flowers,&nbsp;S. Subhadarshani,&nbsp;S. Quinter,&nbsp;C. Shaughnessy","doi":"10.1002/jvc2.560","DOIUrl":"https://doi.org/10.1002/jvc2.560","url":null,"abstract":"<p>Eosinophilic pustular folliculitis (EPF) is a noninfectious follicular based inflammatory dermatosis. We present a case of a 57-year-old female of Indian ethnicity who developed a pustular eruption, with certain lesions displaying Koebnerization. Given that the morphologic distribution most represented the immunosuppressant EPF subtype, additional testing led to the discovery of concurrent IgA deficiency. This case highlights a particularly unusual presentation of EPF associated with IgA deficiency and Koebner phenomenon.</p>","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"244-247"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530720","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 retrospective study comparing PUVA therapy with and without maintenance therapy in patients with mycosis fungoides in a real-word clinical practice","authors":"Bernadette Eberlein,&nbsp;Lorenz Frasheri,&nbsp;Rüdiger Hein,&nbsp;Christian Posch,&nbsp;Oana-Diana Persa","doi":"10.1002/jvc2.552","DOIUrl":"https://doi.org/10.1002/jvc2.552","url":null,"abstract":"&lt;p&gt;PUVA therapy is recommended in all stages of mycosis fungoides (MF) and can be combined with other therapies depending on the stage.&lt;span&gt;&lt;sup&gt;1-4&lt;/sup&gt;&lt;/span&gt; Complete response rates for oral PUVA were calculated to be 85% for stage IA, 65% for stage IB, and 85% for stage IIA. A prospective study from 2019 revealed improved remission with 9 months of maintenance therapy after the induction phase (12–24 weeks) compared to no maintenance.&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt; The aim of this retrospective study was to compare patients with MF receiving PUVA treatment with maintenance therapy (adapted to the above-mentioned prospective study) from the years 2020–2024 with patients receiving PUVA treatment without maintenance therapy from the years 2013–2019.&lt;/p&gt;&lt;p&gt;Twenty-five and 22 analysable patients with histologically confirmed MF were presented to the photodermatology unit for PUVA therapy in the years 2013–2019 (group 1) and 2020–2024 (group 2) respectively. Treatment in the PUVA induction phase was usually administered four times a week for up to 6 weeks with increasing UVA doses for both groups. Additionally, PUVA maintenance therapy was usually administered for 9 months (first month: every week; second and third month: every 2 weeks; fourth to ninth month: every 4 weeks) with the last UVA dose of the induction phase in group 2. The type of PUVA therapy, the number of treatments, the single dose and the cumulative doses were documented. Application of topical steroids was allowed, and systemic drugs were used in some patients (Table 1). Clinical evaluation of the response was performed every week during the induction phase, regularly during the maintenance therapy and afterwards every 3–6 months depending on the stage of the disease. The assessment with regard to remission (complete response, partial response) or progression (progressive disease, relapse) according to previously published criteria&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; was determined 1 year after the start of the induction phase. Statistical analysis was performed with the chi-squared test. The threshold for statistical significance was set to &lt;i&gt;p&lt;/i&gt; &lt; 0.05. The odds ratio (OR) was calculated using MedCalc (MedCalc Software Ltd, Ostend, Belgium).&lt;/p&gt;&lt;p&gt;Details of sex, age, type of PUVA therapy, systemic treatments alongside PUVA therapy, mean cumulative dose and mean number of irradiations can be found in Table 1. Out of the 25 patients in group 1, 11 experienced remission, while 15 out of the 22 patients in group 2 had a remission (44% vs. 68%, n.s., &lt;i&gt;p&lt;/i&gt; = 0.096). One patient of group 2 is shown in Figure 1. The OR for remission with PUVA maintenance therapy compared to induction PUVA only was 2.73 with a 95% confidence interval of 0.83–9.01 and a p-value of 0.10.&lt;/p&gt;&lt;p&gt;This retrospective study suggests a trend towards improved rates of remission using PUVA maintenance at year 1. This short follow-up period and the small sample size are limitations of the study. In a prospective stud","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"4 1","pages":"299-303"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530712","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":"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":"Claudine Howard-James,&nbsp;Claire Quigley,&nbsp;Caoimhe Dalton,&nbsp;Anne-Marie Tobin","doi":"10.1002/jvc2.557","DOIUrl":"https://doi.org/10.1002/jvc2.557","url":null,"abstract":"&lt;p&gt;We read with great interest the recent article by Bowe et al. on the attitudes of Irish patients to biobanking. It is heartening to learn that the majority of patients, healthcare workers and members of the public in Ireland are willing to donate biospecimens for medical research purposes.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Biobanks are vital to the progression of medical research, and can be defined as structured collections of biological samples and associated data stored for the purposes of present and future research.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; One of the most recognised is the UK Biobank, a database containing genetic, lifestyle and health information from half a million UK participants. Recent UK Biobank data shows malignant melanoma is the fourth most common prevalent malignant cancer and the second most common incident malignant cancer in the 40–49 years age group.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;This willingness of patients to participate in biobanking is not always reflected in the literature. In a literature search conducted on PubMed using the terms ‘biobank’ or ‘biobanking,’ ‘attitudes’ and ‘public’; 337 abstracts were identified. These were reviewed for suitability by the authors and 62 deemed appropriate for inclusion as they contained content specific to public attitudes towards biobanking. Overall, the literature reveals a lack of knowledge of biobanking amongst the general public but a generally positive public opinion on the subject.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; A further literature search was conducted with a melanoma-specific focus on PubMed using the terms ‘biobank’ or ‘biobanking,’ ‘melanoma’ and ‘public.’ This search identified 55 abstracts, which were reviewed for suitability by the authors. There were no papers identified with content specific to public attitudes towards biobanking in melanoma, while there were 32 papers which analysed UK Biobank data for cancer research including in melanoma. We also looked at social media. Targeted searches were performed on TikTok, Facebook, Instagram and Twitter/X using the terms or hashtags ‘biobank’ and ‘biobanking’. The top 10 results on each site were analysed to identify content creator demographics, number of views and/or followers of the page, the type of content and associated hashtags or themes, as outlined in Table 1. On TikTok, the most common demographic of content creator was healthcare professionals, while on the other platforms the most common demographic was research organisations. The reach on TikTok was found to be greater than other platforms, with a mean of 20,100 views per post (range 300–96,000) and an average follower count of 4816. This compares to a mean follower count of 3497 on Instagram, 4340 on Facebook and 4688 on Twitter/X. The type of content across all platforms was predominantly educational, followed by advertising. The most common themes across all platforms were genomics and cancer research. Across all platforms, none of the top posts mentioned biobanking in the","PeriodicalId":94325,"journal":{"name":"JEADV clinical practice","volume":"3 5","pages":"1713-1715"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jvc2.557","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762760","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}