Dermatological Toxicities of Bruton ’s Tyrosine Kinase Inhibitors
AbstractThe development of Bruton ’s tyrosine kinase (BTK) inhibitors represents a major breakthrough in the treatment of chronic lymphocytic leukemia and other B cell malignancies. The first-generation inhibitor ibrutinib works by covalent irreversible binding to BTK, a non-receptor tyrosine kinase of the TEC (transient erythrobl astopenia of childhood) family that plays a critical role in the B-cell receptor signaling pathway. It also induces an ‘off-target’ inhibition of a range of other kinases including (but not limited to) epidermal growth factor receptor (EGFR), SRC, and other kinases of the T...
Source: American Journal of Clinical Dermatology - July 1, 2020 Category: Dermatology Source Type: research

Progress to Date in Advancing Stratified Medicine in Psoriasis
AbstractStratified medicine is the tailoring of treatment to the individual characteristics of each patient. This is a challenging task in the context of psoriasis, a complex disease with a variety of phenotypic presentations and a comorbidity burden that extends beyond cutaneous manifestations. In recent years, considerable progress has been made in understanding the immunology of psoriasis, and this has informed the development of increasingly precise and efficacious therapies. However, not all patients respond to biologic therapy, and access is limited to patients with moderate  to severe disease. However, sub...
Source: American Journal of Clinical Dermatology - June 30, 2020 Category: Dermatology Source Type: research

Emerging Therapeutic Options for Chronic Pruritus
AbstractChronic pruritus, defined as an unpleasant sensation resulting in a need to scratch that lasts more than 6  weeks, is a prevalent and bothersome symptom associated with both cutaneous and systemic conditions. Due to complex pathogenesis and profuse contributing factors, chronic pruritus therapy remains challenging. Regardless of the well-established antipruritic properties of classic pharmacotherapy (to pical therapy, phototherapy and systemic therapy), these methods often provide insufficient relief for affected individuals. Owing to the growing interest in the field of pruritic research, further experimental...
Source: American Journal of Clinical Dermatology - June 30, 2020 Category: Dermatology Source Type: research

Bedside Diagnostics for Infections: A Guide for Dermatologists
AbstractIn dermatology, there are many bedside diagnostic tests that may aid in more rapid diagnosis and early initiation of appropriate therapy. When performed correctly, these bedside diagnostic tests can provide both sensitive and specific results. We discuss bedside diagnostic tests, such as the Tzanck smear, potassium hydroxide (KOH) preparation, and mineral oil preparation, with a specific focus on their use in diagnosing infectious dermatoses. (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - June 19, 2020 Category: Dermatology Source Type: research

Dupilumab Provides Favorable Safety and Sustained Efficacy for up to 3 Years in an Open-Label Study of Adults with Moderate-to-Severe Atopic Dermatitis
ConclusionThese safety and efficacy results support dupilumab as a continuous long-term treatment for adults with moderate-to-severe AD.Trial RegistrationClinicalTrials.gov: NCT01949311.Video abstractDupilumab provides favorable safety and sustained efficacy for up to 3 years in an open-label study of adults with moderate-to-severe atopic dermatitis (MP4  139831 kb) (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - June 17, 2020 Category: Dermatology Source Type: research

New and Emerging Targeted Therapies for Vascular Malformations
AbstractVascular malformations are inborn errors of vascular morphogenesis and consist of localized networks of abnormal blood and/or lymphatic vessels with weak endothelial cell proliferation. They have historically been managed by surgery and sclerotherapy. Extensive insight into the genetic origin and molecular mechanism of development has been accumulated over the last 20  years. Since the discovery of the first somatic mutations in a vascular anomaly 10 years ago, it is now recognized that they are perhaps all caused by inherited or somatic mutations in genes that hyperactivate two major intracellular signal...
Source: American Journal of Clinical Dermatology - June 15, 2020 Category: Dermatology Source Type: research

Primary Cutaneous Coccidioidomycosis: An Update
AbstractCoccidioidomycosis is an endemic mycosis of the southern United States, Northern Mexico, and South America. Primary cutaneous coccidioidomycosis, despite being a very rare clinical presentation, has shown an increasing incidence. An extensive literature search for cutaneous coccidioidomycosis cases was performed using the OLDMEDLINE, PubMed, Cochrane, LILACS and Google Scholar databases for studies published from January 1927 through December 21, 2019. Forty-two observational studies were included totaling 82 cases of primary cutaneous coccidioidomycosis. Narrative reviews, systematic reviews, and meta-analyses wer...
Source: American Journal of Clinical Dermatology - June 15, 2020 Category: Dermatology Source Type: research

Dermatologic Laser Side Effects and Complications: Prevention and Management
AbstractThe evolution of modern laser and light-based systems has mirrored the demand for clinically effective treatments and the need for safer technologies with reduced postoperative recovery, side effects, and complications. With each new generation of lasers, more selective tissue destruction can be achieved with reduced unwanted sequelae. Patient selection and preparation, operator technique, and expeditious recognition and management of post-treatment side effects are paramount in avoiding complications and patient dissatisfaction. An overview of important variables to consider for dermatologic laser treatments are p...
Source: American Journal of Clinical Dermatology - June 11, 2020 Category: Dermatology Source Type: research

Efficacy of Nonprescription Moisturizers for Atopic Dermatitis: An Updated Review of Clinical Evidence
AbstractTwice-daily moisturization is recommended by international guidelines as the bedrock of the management of atopic dermatitis (AD). Moisturizers should be selected based on proven clinical effectiveness in improving the skin barrier and improving the symptoms of AD. We searched the PubMed database for clinical trials assessing daily moisturization for the treatment of AD published between 2006 and 2019. Studies had to assess the efficacy of commercially available moisturizers using objective measures of corneometry, transepidermal water loss, or incidence of flare as endpoints, and treatments had to be currently avai...
Source: American Journal of Clinical Dermatology - June 10, 2020 Category: Dermatology Source Type: research

Vitiligo and Melanoma-Associated Vitiligo: Understanding Their Similarities and Differences
ConclusionsCo-opting the immune system to target tumor antigens highlights the potential overlap between anti-tumor immunity and autoimmunity. The development of vitiligo-like depigmentation in association with immunotherapy for melanoma may provide insights into both the immune response against melanoma as well as the pathogenesis of vitiligo. (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - May 28, 2020 Category: Dermatology Source Type: research

Topical Minocycline Foam 4%: A Review in Acne Vulgaris
AbstractTopical minocycline foam  4% (Amzeeq™) is approved in the USA for the treatment of inflammatory lesions of non-nodular, moderate to severe acne vulgaris (acne) in patients aged ≥ 9 years. It was developed to minimize systemic minocycline absorption and toxicity, and its high lipid content allows efficient drug mov ement through sebum and into affected sites. The favorable in vitro resistance profile of oral minocycline seen inCutibacterium acnes (C. acnes) isolates was maintained with topical minocycline foam  4%. In 12-week, phase III clinical trials, once-daily topical m...
Source: American Journal of Clinical Dermatology - May 28, 2020 Category: Dermatology Source Type: research

Fabric Selection in Atopic Dermatitis: An Evidence-Based Review
ConclusionsAppropriate fabric selection can reduce the symptom severity and exacerbations of atopic dermatitis. (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - May 21, 2020 Category: Dermatology Source Type: research

Treatment Goals in Psoriasis: Which Outcomes Matter Most?
AbstractPsoriasis is a chronic immune-mediated inflammatory disease that predominantly affects the skin and joints. Its detrimental effects on the physical, psychosocial, and emotional well-being of patients leads to a significant reduction in quality of life (QoL). The goals of treatment focus on decreasing disease severity and improving QoL for patients; accomplishing these goals requires physicians to understand both the full impact of the disease on a patient ’s life and the outcomes that matter most to patients. The use of outcome measures, both physician- and patient-reported, can assist clinicians in evaluatin...
Source: American Journal of Clinical Dermatology - May 18, 2020 Category: Dermatology Source Type: research

Dermatologic Sequelae Associated with Radiation Therapy
The objective of this paper was to review the literature regarding cutaneous manifestations associated with radiation therapy in order to promote awareness of the cutaneous radiation therapy-associated adverse effects. This extensive literature review was performed using the Pubmed and Embase databases. Studies were reviewed for relevance and critical evidence pertaining to cutaneous manifestations of radiation therapy. The most commonly reported cutaneous sequelae associated with radiation therapy include radiation dermatitis, non-melanoma skin cancer, radiation-associated angiosarcoma, morphea, bullous pemphigoid, lympha...
Source: American Journal of Clinical Dermatology - May 14, 2020 Category: Dermatology Source Type: research

Eosinophilic Dermatoses: Recognition and Management
AbstractEosinophilic dermatoses  encompass a broad spectrum of diseases of different etiologies hallmarked by eosinophilic infiltration of the skin and/or mucous membranes, with or without associated blood eosinophilia. The wide range of dermatological manifestations of this spectrum, including nodules and plaques, pustules, bl isters, ulcers, and urticarial lesions, is reflected in a non-univocal classification system. We identified six groups of eosinophilic dermatoses based on the predominant anatomic level of involvement: (1) epidermal; (2) of the dermal–epidermal junction; (3) dermal; (4) of the h...
Source: American Journal of Clinical Dermatology - May 11, 2020 Category: Dermatology Source Type: research

A Review of Noninvasive Techniques for Skin Cancer Detection in Dermatology
AbstractAs a result of increasing melanoma incidence and challenges with clinical and histopathologic evaluation of pigmented lesions, noninvasive techniques to assist in the assessment of skin lesions are highly sought after. This review discusses the methods, benefits, and limitations of adhesive patch biopsy, electrical impedance spectroscopy (EIS), multispectral imaging, high-frequency ultrasonography (HFUS), optical coherence tomography (OCT), and reflectance confocal microscopy (RCM) in the detection of skin cancer. Adhesive patch biopsy provides improved sensitivity and specificity for the detection of melanoma with...
Source: American Journal of Clinical Dermatology - May 7, 2020 Category: Dermatology Source Type: research

New and Emerging Biologics for Atopic Dermatitis
AbstractAtopic dermatitis (AD) is a chronic inflammatory skin disease that is characterized by complex pathophysiology involving both skin barrier dysfunction and aberrant type 2 inflammation/immune responses. AD can be a debilitating condition that drastically impairs quality of life, especially in patients with moderate-to-severe disease. Currently, topical therapies such as corticosteroids and non-steroidal immunomodulatory therapy provide limited efficacy for patients with moderate-to-severe AD; limitations include inadequate response, cutaneous toxicity from overuse, and poor tolerance due to stinging and burning. His...
Source: American Journal of Clinical Dermatology - April 22, 2020 Category: Dermatology Source Type: research

Managing Cutaneous Immune-Mediated Diseases During the  COVID-19 Pandemic
AbstractCoronavirus disease 2019 (COVID-19) is a clinical syndrome caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2  (SARS-CoV-2). COVID-19 has spread rapidly worldwide and has been shown to have a wide spectrum of severity. COVID-19 has become a public health emergency of relevant international concern, and it was declared a pandemic by the World Health Organization on 11 March, 2020. SARS-CoV-2 infection in se vere cases involves the host response as an important contributor to the disease process and tissue damage, mainly due to dysregulated and excessive innate immune responses....
Source: American Journal of Clinical Dermatology - April 10, 2020 Category: Dermatology Source Type: research

Safety, Effectiveness, and Pharmacokinetics of Crisaborole in Infants Aged 3 to   & lt;  24 Months with Mild-to-Moderate Atopic Dermatitis: A Phase IV Open-Label Study (CrisADe CARE 1)
AbstractBackgroundCrisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate atopic dermatitis (AD).ObjectivesThe aim of this study was to evaluate the safety, effectiveness, and pharmacokinetics (PK) of crisaborole in infants aged 3 to  
Source: American Journal of Clinical Dermatology - March 24, 2020 Category: Dermatology Source Type: research

Malignancy Rates in Brodalumab Clinical Studies for Psoriasis
ConclusionsRates of malignancy among brodalumab-treated patients with psoriasis were generally low.Trial registryClinicalTrials.gov identifier NCT00975637; NCT01101100; NCT01708590 (AMAGINE-1); NCT01708603 (AMAGINE-2); NCT01708629 (AMAGINE-3). (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - March 23, 2020 Category: Dermatology Source Type: research

A Review Comparing International Guidelines for the Management of Bullous Pemphigoid, Pemphigoid Gestationis, Mucous Membrane Pemphigoid, and Epidermolysis Bullosa Acquisita
AbstractAutoimmune blistering disease management can be challenging as treatment modalities vary greatly and no single standard of care exists. We consolidated the recommendations of international management guidelines in order to provide optimal management suggestions to physicians. A comprehensive literature search in PubMed/MEDLINE for published blistering disease management guidelines and consensus statements was conducted in November 2019. Search terms included “guideline or guidelines” or “consensus” and “pemphigoid” or “autoimmune blistering disease” or “epidermo...
Source: American Journal of Clinical Dermatology - March 16, 2020 Category: Dermatology Source Type: research

Oral Spironolactone for Acne Vulgaris in Adult Females: An Update of the Literature
(Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - March 12, 2020 Category: Dermatology Source Type: research

Long-Term Outcomes in BRAF -Mutated Melanoma Treated with Combined Targeted Therapy or Immune Checkpoint Blockade: Are We Approaching a True Cure?
AbstractApproximately 50% of all melanomas harbor an activatingBRAF mutation. In patients suffering from an advanced melanoma with such a somatic alteration, combined targeted therapy with a BRAF and MEK inhibitor can be applied to significantly increase the survival probability. Nevertheless, resistance mechanisms, as well as negative predictive biomarkers (elevated lactate dehydrogenase levels, high number of metastatic organ disease sites, brain metastasis), remain a major problem in treating melanoma patients. Recently, a landmark overall survival (OS) rate of 34% after 5  years of combined targeted therapy in tre...
Source: American Journal of Clinical Dermatology - March 2, 2020 Category: Dermatology Source Type: research

Optimizing Isotretinoin Treatment of Acne: Update on Current Recommendations for Monitoring, Dosing, Safety, Adverse Effects, Compliance, and Outcomes
AbstractAcne vulgaris is the most common skin disease treated by dermatologists. It can be severe and result in permanent scars. Isotretinoin is the most effective treatment for acne and has the potential for long-term clearance. Prescribing and monitoring protocols can vary widely among prescribers. Recent studies, reports, and consensus statements help shed light on optimizing the use of isotretinoin for acne. A recent literature review is summarized in this article to help the practitioner optimize isotretinoin use for acne. The article outlines the advantages and disadvantages of standard, high-dose, and low-dose isotr...
Source: American Journal of Clinical Dermatology - February 27, 2020 Category: Dermatology Source Type: research

Dermatomyositis: An Update on Diagnosis and Treatment
AbstractDermatomyositis is a rare inflammatory disease with characteristic cutaneous findings and varying amounts of systemic involvement. Patients may present with skin disease alone, have concomitant muscle disease, or have extracutaneous manifestations such as pulmonary disease or an associated malignancy. Given such diverse presentations, dermatomyositis is both a diagnostic and therapeutic challenge. However, a prompt diagnosis is of utmost importance to institute adequate therapy and screen patients for an associated malignancy. Dermatologists should play a crucial role in the diagnosis and management of patients wit...
Source: American Journal of Clinical Dermatology - February 24, 2020 Category: Dermatology Source Type: research

Baseline Characteristics from UNITE: An Observational, International, Multicentre Registry to Evaluate Hidradenitis Suppurativa (Acne Inversa) in Clinical Practice
AbstractBackgroundHidradenitis suppurativa (HS), also known as acne inversa, is a recurring, painful, chronic, and sometimes disfiguring inflammatory skin disease.ObjectivesOur objective was to report the baseline clinical characteristics, natural history, and associated outcomes of patients with HS from the ongoing, prospective, non-interventional UNITE registry that is collecting data regarding the natural history and associated outcomes of HS.MethodsPatients with inflammatory HS lesions were enrolled, including adolescents (aged 12 to
Source: American Journal of Clinical Dermatology - February 19, 2020 Category: Dermatology Source Type: research

Safety and Effectiveness of Anti-Tumor Necrosis Factor-Alpha Biosimilar Agents in the Treatment of Psoriasis
AbstractBiologic drugs have revolutionized the treatment of psoriasis and other chronic inflammatory diseases. In recent years, many tumor necrosis factor-alpha ‘biosimilar’ agents have been developed. These biosimilars are similar in structure and function to their originator molecules, although they are not identical. Given that the safety and efficacy of the original biologic have already been proven, biosimilars are only required to show bioequivale nce, or non-inferiority, to the reference biologic to be approved. Based on extrapolation of these non-inferiority data, biosimilars may be subsequently approve...
Source: American Journal of Clinical Dermatology - February 11, 2020 Category: Dermatology Source Type: research

When is it OK to Stop Anti-Programmed Death 1 Receptor (PD-1) Therapy in Metastatic Melanoma?
AbstractSystemic therapy for metastatic melanoma has been revolutionized over the past decade with the development of highly effective immune checkpoint inhibition, specifically anti-Programmed Death  1 receptor (PD-1) therapy. However, even though one-third of patients will have durable response to single-agent or combination therapy, the optimal duration of therapy is unknown. Identifying the optimal duration of therapy is important, as exposure to anti-PD-1 therapy increases the risk of deve loping immune-mediated toxicities that can have significant morbidity and are, at times, fatal. It has long been understood t...
Source: American Journal of Clinical Dermatology - February 5, 2020 Category: Dermatology Source Type: research

Palmoplantar Pustulosis: Recent Advances in Etiopathogenesis and Emerging Treatments
AbstractPalmoplantar pustulosis (PPP) is a chronic, recurrent skin disease belonging to the spectrum of psoriasis. It is characterized by an eruption of sterile pustules on the palms and soles. Recent studies in PPP have focused on genetic differences between pustular phenotypes and the role of the innate immunological system and the microbiome in the etiopathogenesis of the disease. Mutations inIL36RN (a major predisposing factor for generalized pustular psoriasis) were found in selected patients with PPP and were associated with earlier disease onset. Studies have shown that the interleukin (IL)-17 and IL-36 pathways mig...
Source: American Journal of Clinical Dermatology - February 1, 2020 Category: Dermatology Source Type: research

Fixed Drug Eruptions: An Update, Emphasizing the Potentially Lethal Generalized Bullous Fixed Drug Eruption
AbstractA fixed drug eruption (FDE) is a relatively common reaction associated with more than 100 medications. It is defined as a same-site recurrence with exposure to a particular medication. The primary approach and treatment for all types of FDEs are to identify and remove the causative agent, often accomplished by a thorough history of medication and other chemical exposures, and possibly prior episodes. The most common category of FDE, localized FDE, whether bullous or non-bullous, is self-limited. Although one can confirm the causative agent using oral challenge testing, it is not recommended due to the risk of sever...
Source: American Journal of Clinical Dermatology - January 30, 2020 Category: Dermatology Source Type: research

Conjunctival Melanoma: Current Treatments and Future Options
AbstractConjunctival melanoma is a rare tumor of the conjunctival epithelium with a heterogenous clinical presentation and a propensity for regional and distant metastatic spread. Guidelines for the treatment of local conjunctival melanoma are well-established, but there are no standard efficacious therapies for metastatic disease. Given that conjunctival melanoma is genetically similar to cutaneous melanoma and mucosal melanomas, targeted therapies effective in the treatment of these diseases, such as BRAF inhibitors and KIT inhibitors, may be effective in the treatment of patients with metastatic conjunctival melanoma. O...
Source: American Journal of Clinical Dermatology - January 21, 2020 Category: Dermatology Source Type: research

Non-Classic Signs of S ézary Syndrome: A Review
AbstractThe majority of patients with S ézary syndrome (SS) present with classic symptoms of erythroderma, lymphadenopathy, and pruritus. However, there have been numerous reports of patients with SS who have non-classic signs. In this review, we report the less common clinical presentations of SS and discuss their relevant treatments. O ur search included all literature on SS since 2008, the year the World Health Organization (WHO) incorporated the diagnostic criteria for SS into theWHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. We reviewed 896 articles and identified 505 patients with non-cl...
Source: American Journal of Clinical Dermatology - January 17, 2020 Category: Dermatology Source Type: research

Investigator and Patient Global Assessment Measures for Psoriasis Clinical Trials: A Systematic Review on Measurement Properties from the International Dermatology Outcome Measures (IDEOM) Initiative
ConclusionsThe 5- and 6-point investigator global assessments, which are the most widely used investigator global assessments in registered clinical trials, have less evidence for measurement properties as compared with the Lattice System-Physician Global Assessment, professional-Simplified Psoriasis Index, and the Product of the Investigator Global Assessment and Body Surface Area. However, all instruments lack evidence for content validity and feasibility. Further validation studies of investigator global assessments and patient global assessments are required to recommend the best global measure for psoriasis clinical t...
Source: American Journal of Clinical Dermatology - January 16, 2020 Category: Dermatology Source Type: research

Diabetic Foot Ulcers: Appraising Standard of Care and Reviewing New Trends in Management
AbstractDiabetic foot ulcers (DFU) are one of the most common diabetes complications and are associated with significant morbidity and mortality. Current DFU standard of care (SOC) involves four principles: (1) pressure relief, (2) debridement, (3) infection management, and (4) revascularization when indicated. Despite the current SOC, many DFU persist, warranting a new approach for the management of these complex wounds. This review aims to summarize the current SOC as well as the latest trends in adjunctive therapies that may become the new SOC in DFU management. These include negative pressure wound therapy and hyperbar...
Source: American Journal of Clinical Dermatology - December 17, 2019 Category: Dermatology Source Type: research

Psoriatic Disease in the US Latino Population: A Comprehensive Review
AbstractCurrent evidence suggests that there are notable differences in the severity of psoriasis between racial and ethnic groups. While the US Latino population is growing rapidly, there is little research on the various factors impacting disease severity in this minority population. This review evaluates the current evidence on psoriasis in Latinos within the US. Psoriasis affects the US Latino population at a lower prevalence, with more severe disease and a greater quality-of-life impact than their White counterparts. In addition, Latinos with psoriasis experience higher rates of comorbidities, such as depression, obes...
Source: American Journal of Clinical Dermatology - December 16, 2019 Category: Dermatology Source Type: research

Laser and Light-Based Treatment Modalities for the Management of Hidradenitis Suppurativa
AbstractHidradenitis suppurativa is a chronic inflammatory skin disease characterized by inflammatory nodules, abscesses, and sinus tracts in intertriginous areas that has a significant impact on patient quality of life. Treatments range from topical, intralesional, systemic, and surgical. Furthermore, laser and light-based treatment options have become increasingly popular because of the limitations of adverse effects associated with systemic therapy and decreased down-time associated with laser and light therapy. These modalities are thought to work through a variety of mechanisms including decreasing inflammation, destr...
Source: American Journal of Clinical Dermatology - December 16, 2019 Category: Dermatology Source Type: research

Rituximab: A Review in Pemphigus Vulgaris
AbstractRituximab (MabThera®, Rituxan®), a chimeric murine/human anti-CD20 monoclonal antibody administered by intravenous infusion, is indicated for the treatment of moderate to severe pemphigus vulgaris (PV), in combination with a tapering course of corticosteroids. Approval in the EU and USA was based on data for the subset of patients with newly-diagnosed, previously untreated PV participating in the randomized, controlled RITUX 3 study; rituximab plus short-course prednisone resulted in a  >  3-fold higher rate of complete remission off prednisone therapy and a >  2-fold decre...
Source: American Journal of Clinical Dermatology - December 14, 2019 Category: Dermatology Source Type: research

Sensitive Skin Syndrome: An  Update
AbstractSensitive skin syndrome is a widely reported complaint but a diagnostic challenge because of its subjective symptoms and lack of clearly visible manifestations. Epidemiological studies have shown the prevalence of sensitive skin to be as high as 60 –70% among women and 50–60% among men. Patients with this syndrome usually have unpleasant sensations when exposed to physical, thermal, or chemical stimuli that normally cause no provocation on healthy skin. Recent studies and newly accepted position papers have provided a more in-depth underst anding and consensus of its underlying pathophysiology, associat...
Source: American Journal of Clinical Dermatology - December 13, 2019 Category: Dermatology Source Type: research

Topical Antiandrogen Therapies for Androgenetic Alopecia and Acne Vulgaris
AbstractAndrogenetic alopecia (AGA) and acne vulgaris are two conditions commonly seen by dermatologists. Androgens and the androgen receptors play an essential role in the manifestation of both conditions, and some systemic therapies function by interfering in this pathway. The use of topical antiandrogen therapies has gained traction in recent years due to their potential efficacy in treating AGA and acne vulgaris, as well as their reduced adverse effects compared with systemic drugs. This review discusses the role of androgens in skin physiology and pathology and assesses the potential efficacy and safety of three topic...
Source: American Journal of Clinical Dermatology - December 12, 2019 Category: Dermatology Source Type: research

Clinically Meaningful Responses to Dupilumab in Adolescents with Uncontrolled Moderate-to-Severe Atopic Dermatitis: Post-hoc Analyses from a Randomized Clinical Trial
The objective of this study was to assess the impact of dupilumab treatment vs. placebo on the achievement of clinically meaningful improvements in atopic dermatitis signs, symptoms and quality of life.MethodsR668-AD-1526 LIBERTY AD ADOL was a randomized, double-blinded, parallel-group, phase III clinical trial. Two hundred and fifty-one adolescents with moderate-to-severe atopic dermatitis received dupilumab 300  mg every 4 weeks (q4w;n  =  84), dupilumab 200 or 300 mg every 2 weeks (q2w;n  =  82), or placebo (n  =  85). A post-hoc subgroup analysis was performed on...
Source: American Journal of Clinical Dermatology - December 10, 2019 Category: Dermatology Source Type: research

Neurological Cancer is a Risk Factor for Bullous Pemphigoid: 11-Year Population-Based Cohort Study
ConclusionsNeurological cancer increased the risk for subsequent BP by 2.4-fold, with a relatively short gap of 4.5  years. (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - December 9, 2019 Category: Dermatology Source Type: research

Generalized Pustular Psoriasis: Clinical Management and Update on Autoinflammatory Aspects
AbstractGeneralized pustular psoriasis (GPP) is a chronic, systemic inflammatory disease accompanied by high fever and general malaise. Diffuse erythema and swelling of the extremities occur, with multiple sterile pustules all over the body in GPP patients. GPP often relapses over the lifetime and can be life-threatening. Recent discoveries of the underlying molecular genetic basis of many cases of this disorder have provided major advances to clinicians and researchers towards an understanding of the pathomechanism of GPP. However, the therapeutic management of GPP still faces many challenges and much uncertainty, and an ...
Source: American Journal of Clinical Dermatology - December 7, 2019 Category: Dermatology Source Type: research

Melasma Treatment: An Evidence-Based Review
ConclusionsHydroquinone monotherapy and triple combination cream are the most effective and well-studied treatments for melasma, whereas chemical peels and laser- and light-based therapies are equal or inferior to topicals, but offer a higher risk of adverse effects. Oral tranexamic acid may be a safe, systemic adjunctive treatment for melasma, but more studies are needed to determine its long-term safety and efficacy. Limitations of the current evidence are heterogeneity of study design, small sample size, and lack of long-term follow-up, highlighting the need for larger, more rigorous studies in the treatment of this rec...
Source: American Journal of Clinical Dermatology - December 4, 2019 Category: Dermatology Source Type: research

Ixekizumab Effectiveness and Safety in the Treatment of Moderate-to-Severe Plaque Psoriasis: A Multicenter, Retrospective Observational Study
The objective of this study was to evaluate the effectiveness and safety of ixekizumab in a cohort of psoriatic and psoriatic arthritis patients.MethodsWe conducted a retrospective study involving 201 patients affected by moderate-to-severe psoriasis and treated with ixekizumab at seven Italian University centers. Data analysis focused on 110 patients who started ixekizumab at baseline and completed at least 24  weeks of treatment.ResultsSignificant reduction of mean ( ± standard deviation) baseline Psoriasis Area Severity Index (PASI) score (14.3 ± 5.8) was detected at 4 weeks ...
Source: American Journal of Clinical Dermatology - November 30, 2019 Category: Dermatology Source Type: research

Malignant Melanoma of the Vulva and Vagina: A US Population-Based Study of 1863 Patients
The objective of this study was to describe the epidemiology and prognosis of VuM and VaM in a large representative cohort.MethodsWomen with invasive VuM or VaM were identified from the Surveillance, Epidemiology and End Results-18 population representing 27.8% of the US population. Data on age, ethnicity, stage, location, histopathology, primary surgery, and lymphadenectomy were collected. The Kaplan –Meier method was used to analyze disease-specific and overall survival. Univariate and multivariate regression models were used to identify factors with a significant association with disease-specific survival.ResultsA...
Source: American Journal of Clinical Dermatology - November 29, 2019 Category: Dermatology Source Type: research

Risk for Suicidal Behavior Among Psoriasis Patients: A Nationwide Cohort Study
ConclusionIn a Taiwanese setting, no link between psoriasis or psoriatic arthritis and suicidal behavior was detected. (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - November 28, 2019 Category: Dermatology Source Type: research

Updates on Botulinum Neurotoxins in Dermatology
This article serves to update readers on the new botulinum toxins that are currently in development or close to market in the USA and Canada, including daxibotulinumtoxin A, prabotulinumtoxin A, letibotulinumtoxin A, and botulinum toxin E. Despite having relatively similar characteristics and equivalent clinical efficacies, these neurotoxins manifest a multitude of unique potential advantages that will be explored in this review, including but not limited to a longer duration of action, the absence of animal-derived components or human albumin, and a rapid onset with short duration of action. (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - November 28, 2019 Category: Dermatology Source Type: research

Effects of Zinc Supplementation on Inflammatory Skin Diseases: A Systematic Review of the Clinical Evidence
Conclusions and implicationsSome preliminary evidence supports the use of zinc in the treatment of acne vulgaris and hidradenitis suppurativa; however, more research is needed with similar methodologies and larger sample sizes in these diseases. Further, zinc may be of some benefit in the treatment plan for atopic dermatitis and diaper dermatitis; however, additional studies should be conducted to further evaluate these potentially positive associations. To date, no evidence is available to suggest that zinc may be of benefit in rosacea and psoriasis; however, limited data are available evaluating the use of zinc in these ...
Source: American Journal of Clinical Dermatology - November 19, 2019 Category: Dermatology Source Type: research

Herpes Zoster Presentation, Management, and Prevention: A Modern Case-Based Review
AbstractHerpes zoster (HZ) is a common cutaneous entity with protean clinical presentations, management options, complication rates, and prevention strategies, all of which are rife with dogma. During an inpatient consultation for HZ, have you ever been approached by a frantic staff or family member, worried that a pregnant, elderly, or infant contact will be ‘infected’ if they get too close? Have your patients ever asked you about their risk of having HZ twice, or claimed that they have frequent ‘recurrences’? In what timeline should antiviral therapy be employed? Is there evidence for prednisone o...
Source: American Journal of Clinical Dermatology - November 18, 2019 Category: Dermatology Source Type: research

Drug-Induced Intracranial Hypertension: A Systematic Review and Critical Assessment of Drug-Induced Causes
ConclusionWe suggest using the term ‘drug-induced intracranial hypertension’ (DIIH) and propose a set of diagnostic criteria for DIIH. Our review attempts to identify DIIH-associated drugs based on a strict diagnostic and drug-causality algorithm, then stratify them into appropriate risks categories. This may ultimately assist phy sicians in counselling patients about the risk of DIIH when prescribing medications and recognizing this uncommon yet sight-threatening condition. (Source: American Journal of Clinical Dermatology)
Source: American Journal of Clinical Dermatology - November 18, 2019 Category: Dermatology Source Type: research