Solar Urticaria
AbstractPurpose of ReviewSolar urticaria (SU) is a rare photodermatosis, characterized by an abrupt onset of urticaria lesions appearing within minutes of light exposure. The disease may have a significant impact on patients ’ quality of life. This review provides an overview of SU, with attention to pathogenesis, workup, differential diagnosis, and treatment. Additionally, we present our stepwise therapeutic approach.Recent FindingsTreatment with omalizumab, a recombinant humanized anti-IgE antibody used as a third line treatment for SU, was shown to be beneficial in 80% of patients with antihistamine refractory dis...
Source: Current Dermatology Reports - May 11, 2019 Category: Dermatology Source Type: research

Pathophysiology, Diagnosis, and Management of Infections in Atopic Dermatitis
AbstractPurpose of ReviewAtopic dermatitis (AD) is a common and chronic inflammatory skin disease. The purpose of this review article is to assess recent changes in the understanding of pathophysiology, diagnosis, and management of infections in AD.Recent FindingsRecent epidemiological studies have confirmed that AD is not only associated with cutaneous infections, but also extra-cutaneous systemic infections. Basic studies have provided evidence that allergic inflammation contribute to increased infections in AD. Clinical use of diluted bleach to prevent infections in AD remains controversial. On the other hand, progress ...
Source: Current Dermatology Reports - May 11, 2019 Category: Dermatology Source Type: research

Legal and Regulatory Issues with Teledermatology
This article provides an overview of the legal and regulatory requirements that providers engaging in teledermatology must consider when structuring telemedicine arrangements and developing a telehealth strategy.Recent FindingsThe numerous state and federal legal and regulatory considerations applicable to teledermatology offerings are rapidly changing: new laws and regulations are proposed and adopted every year.SummaryAt the state level, requirements are often state specific and address a wide variety of topics such as establishing the physician-patient relationship, technology-specific requirements, and practice and pre...
Source: Current Dermatology Reports - May 3, 2019 Category: Dermatology Source Type: research

Implementation of Teledermatology: Theory and Practice
AbstractPurpose of ReviewMultiple factors influence the success and failure of teledermatology programs. We evaluate the current teledermatology literature using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework developed for implementation research. We introduce this framework to encourage a thorough examination of teledermatology ’s implementation including its sustainability. In this way, programs can better realize teledermatology’s promise for enhancing patients’ access to expert dermatologic care in real-world healthcare settings.Recent FindingsWhile teledermatol...
Source: Current Dermatology Reports - May 2, 2019 Category: Dermatology Source Type: research

Risk, Prevention, Diagnosis, and Management of Post-Operative Cutaneous Infection
AbstractPurpose of ReviewDermatologic surgery procedures have low but non-negligible infection rates. This review summarizes current understanding of the risk of post-operative wound infections after cutaneous surgery, the diagnosis and management of post-operative infections, and appropriate use of antibiotic prophylaxis in dermatologic surgery.Recent FindingsAside from specific situations associated with risk for infective endocarditis, prosthetic joint infections, and high-risk cutaneous surgeries, routine prophylactic, or post-operative antibiotic use is no longer the standard of care. Preliminary data suggests that po...
Source: Current Dermatology Reports - April 24, 2019 Category: Dermatology Source Type: research

Photocutaneous Porphyrias
AbstractPurpose of ReviewPorphyrias are a group of eight uncommon-to-rare inherited or acquired metabolic disorders, each caused by enzyme dysfunction at various steps in the heme biosynthetic pathway. Photocutaneous porphyrias are a subset characterized by acute skin pain and/or chronic skin lesions as major features of disease signs and symptoms. Clinical and laboratory features, epidemiology, genetics, pathologic mechanisms, and current and future therapies of the photocutaneous porphyrias are discussed, with emphasis on information reflected in recent literature.Recent FindingsClinical and laboratory investigations of ...
Source: Current Dermatology Reports - April 16, 2019 Category: Dermatology Source Type: research

Actinic Prurigo and Hydroa Vacciniforme
AbstractPurpose of ReviewTo summarize current knowledge pertaining to two photodermatoses, actinic prurigo (AP) and hydroa vacciniforme (HV), both of which routinely have onset in childhood.Recent FindingsAP is an immune-mediated photodermatosis associated with human leukocyte antigen DR4 that commonly features cheilitis and conjunctivitis. It mostly affects American Indian/Latin American Mestizos and rarely white and Asian patients, who manifest different disease phenotypes. The diagnosis is clinical, but follicular cheilitis is a characteristic mucosal biopsy finding, and phototesting may be helpful. Hallmarks of treatme...
Source: Current Dermatology Reports - April 16, 2019 Category: Dermatology Source Type: research

Biosimilars for Psoriasis —Experience from Europe
The objectives of this review are to describe the use of biosimilars in selected European countries, using “real-life” information from members of the International Psoriasis Council (IPC) who are key opinion leaders in dermatology. The use of biosimilars for patients with psoriasis is continuously discussed and reviewed by the IPC, through in-person meetings by members of the Biosimilar Working Grou p (BSWG).Recent FindingsIn preparation for this paper, we surveyed the use of biosimilars for patients with psoriasis through European BSWG members, who were asked to describe the situation in their countries. The ...
Source: Current Dermatology Reports - February 7, 2019 Category: Dermatology Source Type: research

Nanotechnology for Psoriasis Therapy
AbstractPurpose of ReviewTo summarize the use of nanotechnology-based drug delivery systems for psoriasis therapies, focusing on recent studies of treatment efficacy in humans and murine models.Recent FindingsBoth topical and oral psoriasis medications, in addition to alternative psoriasis therapies and siRNAs targeting genes involved in the pathogenesis of psoriasis, have been incorporated into nanocarriers. Numerous studies demonstrate that nanocarriers can enhance the efficacy and reduce side effects of their included drugs through increased skin retention, sustained release, and decreased systemic absorption. However, ...
Source: Current Dermatology Reports - January 30, 2019 Category: Dermatology Source Type: research

Update on Risankizumab for Psoriasis
AbstractPurpose of ReviewThis review highlights the latest data on risankizumab, including efficacy and safety data from recent clinical trials.Recent FindingsIn multiple phase 3 clinical trials, risankizumab was shown to be safe and efficacious. Risankizumab demonstrated superior efficacy to leading active comparators for the induction and maintenance of clear skin and was shown to have a safety profile similar to other biologic therapies currently on the market.SummaryTargeted biologic medications for plaque psoriasis have provided insight into the complex immune pathways that are now understood to lead to the developmen...
Source: Current Dermatology Reports - January 18, 2019 Category: Dermatology Source Type: research

Tildrakizumab for Moderate-to-Severe Chronic Plaque Psoriasis: a Review of the Literature
AbstractPurpose of ReviewTo highlight the most recent findings regarding the efficacy and safety of tildrakizumab in the treatment of chronic plaque psoriasis.Recent FindingsRecent clinical trials have shown tildrakizumab to be more efficacious than placebo or etanercept. There are no head-to-head trials directly comparing tildrakizumab to any IL-23 p19, IL-17, or IL-17R inhibitor. Common adverse effects included headache, upper respiratory infection, nasopharyngitis, and cough.SummarySince tildrakizumab is a new biologic, there is currently a paucity of available evidence evaluating tildrakizumab in a comparative manor wi...
Source: Current Dermatology Reports - January 16, 2019 Category: Dermatology Source Type: research

The Skin Microbiome in Atopic Dermatitis —a Potential Treatment Target?
AbstractPurpose of ReviewStaphylococcus aureus (S. aureus) frequently colonize the skin of patients with atopic dermatitis (AD). The abundance ofS. aureus increases during flares, accompanied by a reduction in bacterial diversity. This flare-associated imbalance in the cutaneous microflora (dysbiosis) correlates with disease severity. However, the causality of this association has not yet been fully established, and this review aims to further explore the relation between the skin microbiome and AD along with the clinical implications hereof.Recent FindingsRecently, it has been shown that the skin microbiome in clinically ...
Source: Current Dermatology Reports - November 8, 2018 Category: Dermatology Source Type: research

Use of Lasers in Wound Healing: How to Best Utilize Laser Technology to Prevent Scar Formation
AbstractPurpose of ReviewThe purpose of this review is to evaluate the efficacy of early intervention in wound healing on scar formation across multiple scar types and progressions. The types of scars consist of hypertrophic, atrophic, keloid, and contracture scars. The sources of scarring include inflammatory diseases (e.g., acne), surgery, burn, and trauma.Recent FindingsMinimal published research has been done regarding laser treatment in wound healing. Some studies have found promise in minor treatment of surgical wounds but few have sufficient clinical relevance. Recently, further studies have been conducted including...
Source: Current Dermatology Reports - November 5, 2018 Category: Dermatology Source Type: research

Updates on Immunotherapy for the Treatment of Skin Cancer
AbstractPurpose of ReviewSkin cancer is the most common malignancy in the USA, arising when mutated cells escape the host ’s natural immune surveillance. Immunotherapy helps boost the host’s immune system, augmenting the antitumor response. Given the ability of the immune system to evolve with a tumor’s evasive maneuvers, it is not surprising that immunotherapy has demonstrated durable clinical benefit in patient s with cancer, including certain types of skin cancers. Significant progress has been made with the recent development of immunotherapy for skin cancers.Recent FindingsHere, we review the literat...
Source: Current Dermatology Reports - November 3, 2018 Category: Dermatology Source Type: research

Patient Education in Atopic Dermatitis: Why It Is Needed and How to Improve It
AbstractPurpose of ReviewDemonstrate the need and objectives of patient education in atopic dermatitis (AD), provide an overview of the most recent studies regarding patient education, and propose new approaches to improve educational programs.Recent FindingsDifferent models of patient education programs exist, and their structures depend on social and economic conditions. An active participation of patients is needed to improve new models of educational programs. Healthcare professionals who work with AD patients must have a comprehensive view of the many aspects involved in this disease, which includes psychological, env...
Source: Current Dermatology Reports - October 29, 2018 Category: Dermatology Source Type: research

Pediatric Inpatient Dermatology: New Insights on Severe Eruptions and Cutaneous Adverse Reactions
AbstractPurpose of ReviewThis manuscript reviews important advances in our understanding of severe eruptions and cutaneous adverse reactions in children.Recent FindingsThe latest research provides significant insights regarding severe cutaneous eruptions including coxsackievirus eruptions, mycoplasma-induced rash and mucositis, urticaria multiforme, erythema multiforme, and severe cutaneous adverse reactions. Recent literature expands our understanding of the incidence and cost, pathophysiology, and management considerations for pediatric patients with Stevens-Johnson syndrome and toxic epidermal necrolysis.SummaryPediatri...
Source: Current Dermatology Reports - October 25, 2018 Category: Dermatology Source Type: research

Wound Healing with Botanicals: a Review and Future Perspectives
AbstractPurpose of ReviewBotanicals have long played a crucial role in the management of chronic and infected wounds, yet the mechanistic basis of these therapies remains largely poorly understood by modern science.Recent FindingsStudies have begun to unveil the mechanistic bases of botanical therapies for wound healing, but more work is necessary. Most notably, investigation into the growing conditions, post-harvest treatment, and pharmacological preparation of these botanicals has demonstrated their importance in terms of the chemical makeup and pharmacological activity of the final product used in pre-clinical and clini...
Source: Current Dermatology Reports - October 25, 2018 Category: Dermatology Source Type: research

Dermatologic Reactions to Novel Immune Checkpoint Inhibitors
AbstractPurpose of ReviewDermatologic toxicities secondary to immune checkpoint inhibitors are prevalent and can be difficult to manage in the setting of underlying malignancy. This review summarizes the mucocutaneous adverse events associated with these agents and provides management options for varying degrees of presentation.Recent FindingsPruritus and rash are the most common dermatologic findings, but other manifestations such as vitiligo, lichenoid reactions, bullous pemphigoid, alopecia, and mucosal lesions have been observed. More recently, novel cases of rarer side effects, such as immunotherapy-induced scleroderm...
Source: Current Dermatology Reports - October 24, 2018 Category: Dermatology Source Type: research

Healing Chronic Wounds: Current Challenges and Potential Solutions
AbstractPurpose of ReviewThe purpose of this review is to raise awareness, examine the challenges faced by wound care researchers, and explore opportunities for potential improvements.Recent FindingsChronic wounds are associated with significant morbidity and mortality, and they represent a major medical and financial burden. Despite this, no new therapy has received FDA efficacy approval for the treatment of chronic wounds since 1997. Previous preclinical studies using animal models did not translate to human wounds due to inherent limitations of experimental models, variability in assessment methods, and overall experime...
Source: Current Dermatology Reports - October 23, 2018 Category: Dermatology Source Type: research

Advances in Immune Pathways and Pathogenesis of Atopic Dermatitis
AbstractPurpose of ReviewAtopic dermatitis (AD) is a common chronic skin inflammatory disorder characterized by recurrent eczema accompanied by an intractable itch that leads to an impaired quality of life. This review aims to summarize the advances in immune pathways and pathogenesis of AD.Recent FindingsWe review and summarize the current literature characterizing immune pathways and pathogenesis of AD. The complex interplay among skin barrier deficiency, immunological derangement, microbiome dysbiosis especiallyStaphylococcus aureus predominance, and pruritus contribute to the development, progression, and chronicity of...
Source: Current Dermatology Reports - October 22, 2018 Category: Dermatology Source Type: research

Epidemiology and Immunopathogenesis of Psoriasis and Its Comorbidities
AbstractPurpose of ReviewWhile psoriasis has traditionally been considered primarily a skin and joint disorder, there is a new appreciation that psoriasis affects multiple organs. In fact, psoriasis is associated with several comorbidities that also affect the vasculature, guts, lung, kidney, and other tissues. This review aims to summarize the epidemiology and immunopathogenesis of psoriasis and its comorbidities.Recent FindingsWe reviewed the current literature characterizing the epidemiology and immune pathways of psoriasis and its comorbidities and report common inflammatory and immune pathways implicated in the pathog...
Source: Current Dermatology Reports - October 22, 2018 Category: Dermatology Source Type: research

Use of Stem Cells in Wound Healing
AbstractPurpose of ReviewThis review provides an overview of the principal stages of wound healing, the populations of endogenous and therapeutic stem cells, applications of stem cells in specific types of wounds, and current approaches of stem cell delivery for tissue regeneration.Recent FindingsNew uses of progenitor stem cells have been developed for the treatment of wounds. Stem cells improve wound healing through both local and paracrine effects. Stem cell populations of therapeutic utility include embryonic stem cells, induced pluripotent stem cells, adult bone marrow and adipose-derived mesenchymal stem cells, as we...
Source: Current Dermatology Reports - October 6, 2018 Category: Dermatology Source Type: research

Current Psoriasis Efficacy Outcome Measures in Clinical Trials
AbstractPurpose of ReviewThis review sought to examine currently used psoriasis efficacy outcome measures. In particular, we wanted to know what outcome measures are currently being used most frequently, in addition to the advantages and disadvantages of each outcome measure.Recent FindingsIn the past year, Psoriasis Area and Severity Index (PASI) was the most frequently used outcome measure in phase III and IV clinical trials evaluating psoriasis treatments. PASI scores were also the most frequently used primary outcome measure. Psoriasis Scalp Severity Index (PSSI) was the most commonly utilized regional physician report...
Source: Current Dermatology Reports - October 5, 2018 Category: Dermatology Source Type: research

Erythroderma and Figurate Erythemas
AbstractPurpose of ReviewErythroderma and figurate erythemas are common reasons for inpatient dermatologic consultation. This review provides an overview of the frequent causes of erythroderma and figurate erythemas in adults and children as well as highlights recent advances in our understanding of the pathomechanisms of these entities.Recent FindingsWith the advent of immunotherapy for the treatment of cancer, there are new medications that may result in drug-induced erythroderma. Additionally, the pathophysiology and immunologic milieu of erythroderma in psoriasis and cutaneous lymphoma has been investigated. More recen...
Source: Current Dermatology Reports - October 2, 2018 Category: Dermatology Source Type: research

Immunology of Wound Healing
AbstractPurpose of ReviewChronic wounds are a tremendous burden on the healthcare system and lead to significant patient morbidity and mortality. Normal cutaneous wound healing occurs through an intricate and delicate interplay between the immune system, keratinocytes, and dermal cells. Each cell type contributes signals that drive the normal phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This paper reviews how various immunological cell types and signaling molecules influence the way wounds develop, persist, and heal.Recent FindingsConcurrent with the achievement of hemostasis, neutrophi...
Source: Current Dermatology Reports - September 28, 2018 Category: Dermatology Source Type: research

Immune and Inflammatory Reponses to Staphylococcus aureus Skin Infections
AbstractPurpose of ReviewThere have been recent advances in our understanding of cutaneous immune responses to the important human skin pathogen,Staphylococcus aureus (S. aureus). This review will highlight these insights into innate and adaptive immune mechanisms in host defense and cutaneous inflammation in response toS. aureus skin infections.Recent FindingsAntimicrobial peptides, pattern recognition receptors, and inflammasome activation function in innate immunity as well as T cells and their effector cytokines play a key role in adaptive immunity againstS. aureus skin infections. In addition, certain mechanisms by wh...
Source: Current Dermatology Reports - September 22, 2018 Category: Dermatology Source Type: research

Dress for Success: a Review of Dressings and Wound Care in Hidradenitis Suppurativa
AbstractPurpose of ReviewHidradenitis suppurativa is characterized by lesions and draining sinus tracts in intimate locations. Although often overlooked, the selection of an effective, comfortable dressing can dramatically improve patients ’ lives. We aimed to review dressings based on management of post-surgical and non-surgical wound dressings. We reviewed the characteristics and types of dressings used in patients with hidradenitis suppurativa and addressed recommendations for dressing post-surgical and non-surgical wounds.Recent FindingsAvailable studies on dressings are few in number with small sample sizes. The...
Source: Current Dermatology Reports - September 12, 2018 Category: Dermatology Source Type: research

Complementary and Alternative Methods for Treatment of Acne Vulgaris: a Systematic Review
AbstractPurpose of ReviewTo review the current literature regarding complementary and alternative treatment options for acne vulgaris.Recent FindingsAcne vulgaris is an increasingly prevalent disease worldwide. While conventional methods of treatment are still primarily used to treat acne, complementary and alternative methods of treatment are becoming utilized in conjunction or in place of prescription medications.SummaryStudies have shown comparable benefit of Complementary and Alternative Medicine (CAM) therapies to conventional treatment. Oral green tea extract was a moderately effective treatment of inflammatory acne ...
Source: Current Dermatology Reports - September 3, 2018 Category: Dermatology Source Type: research

Skin Barrier Function and Atopic Dermatitis
AbstractPurpose of ReviewThe purpose of this review was to highlight the importance of the skin barrier in the development of atopic dermatitis (AD).Recent FindingsSkin barrier function relies on the stratum corneum (SC) and tight junction. These components are deranged in the AD epidermis. Deficiency in filaggrin gives rise to abnormal epidermal integrity. The intercellular lipid composition, ratio, and organization are found to be disturbed. Keratinocyte shedding from the SC is also impaired. Tight junction proteins are reduced and result in sweat leakage into the skin surface.SummaryStrategies to enhance skin barrier st...
Source: Current Dermatology Reports - September 3, 2018 Category: Dermatology Source Type: research

Complementary and Alternative Methods for Treatment of Acne Vulgaris: a Systematic Review
AbstractPurpose of ReviewTo review the current literature regarding complementary and alternative treatment options for acne vulgaris.Recent FindingsAcne vulgaris is an increasingly prevalent disease worldwide. While conventional methods of treatment are still primarily used to treat acne, complementary and alternative methods of treatment are becoming utilized in conjunction or in place of prescription medications.SummaryStudies have shown comparable benefit of Complementary and Alternative Medicine (CAM) therapies to conventional treatment. Oral green tea extract was a moderately effective treatment of inflammatory acne ...
Source: Current Dermatology Reports - September 3, 2018 Category: Dermatology Source Type: research

Skin Barrier Function and Atopic Dermatitis
AbstractPurpose of ReviewThe purpose of this review was to highlight the importance of the skin barrier in the development of atopic dermatitis (AD).Recent FindingsSkin barrier function relies on the stratum corneum (SC) and tight junction. These components are deranged in the AD epidermis. Deficiency in filaggrin gives rise to abnormal epidermal integrity. The intercellular lipid composition, ratio, and organization are found to be disturbed. Keratinocyte shedding from the SC is also impaired. Tight junction proteins are reduced and result in sweat leakage into the skin surface.SummaryStrategies to enhance skin barrier st...
Source: Current Dermatology Reports - September 3, 2018 Category: Dermatology Source Type: research

Leg Ulcers: Expanding the Differential
AbstractPurpose of ReviewCutaneous lower extremity ulcerations are major source of morbidity and mortality. It can be challenging to identify an underlying etiology. This review provides a systematic framework for generating a thoughtful differential diagnosis and workup approach. We also highlight recent discoveries in the pathophysiology and treatment approaches of leg ulceration.Recent FindingsVenous leg ulceration is being treated with a number of promising new modalities including pentoxifylline, statin therapy, topical timolol, connexin-43 peptide antagonists, photodynamic therapy, and punch grafting. The role of vit...
Source: Current Dermatology Reports - September 1, 2018 Category: Dermatology Source Type: research

Pain Management in Patients with Chronic Wounds
AbstractPurpose of ReviewChronic wounds are increasing in prevalence and are often associated with significant pain, which can have a major impact on quality of life. Safe and effective pain management can be challenging, an unfortunate reality that is highlighted by the ongoing opioid crisis. This review aims to provide an evidence-based framework for pharmacologic and non-pharmacologic pain management in patients with chronic wounds.Recent FindingsAs reflected in the new CDC guidelines, no study has shown that long-term opioid use mitigates chronic pain. Non-pharmacologic therapies, including virtual reality and acupunct...
Source: Current Dermatology Reports - September 1, 2018 Category: Dermatology Source Type: research

Livedoid Vasculopathy: an Updated Review
AbstractPurpose of ReviewTo highlight the most recent findings in the literature on livedoid vasculopathy while providing a basic review of the disease.Recent FindingsLipoprotein(a) and plasminogen activator inhibitor continue to develop evidence supporting their involvement in the pathogenesis of livedoid vasculopathy. Systematic review of the literature has revealed that anticoagulants are the most commonly reported treatments in case series followed by anabolic steroids, antiplatelets, and intravenous immunoglobulins. No randomized or controlled trials have been performed studying treatment efficacy.SummaryThe literatur...
Source: Current Dermatology Reports - September 1, 2018 Category: Dermatology Source Type: research

Pyoderma Gangrenosum: What Do We Know Now?
AbstractPurpose of ReviewTo summarize the recent literature on the pathophysiology, diagnosis, and treatment of pyoderma gangrenosum.Recent FindingsA complex interplay between both the innate and adaptive immune systems underlies the pathogenesis of pyoderma gangrenosum (PG). Diagnosis remains a challenge, as there is no gold standard test to confirm the presence of the disease. Efforts to establish diagnostic criteria based on clinical findings have recently been proposed. Definitive management strategies are also lacking; however, current trends in treatment have favored the use of immunosuppressive medications, wound ca...
Source: Current Dermatology Reports - September 1, 2018 Category: Dermatology Source Type: research

Iatrogenic Dermatoses in Hospitalized Patients
AbstractPurpose of ReviewHospitalized patients are at risk of skin injury from drugs and procedures. These complications carry a high risk of morbidity, mortality, and internal organ involvement. This review examines updates in the treatment of drug eruptions and diagnosis of newly reported iatrogenic skin injuries that accompany novel procedures.Recent FindingsDrug eruptions are a common cause of iatrogenic injury and they vary in presentation and severity. Recent research suggests that medications such as cyclosporine and etanercept may improve mortality in patients with epidermal necrosis although a randomized controlle...
Source: Current Dermatology Reports - September 1, 2018 Category: Dermatology Source Type: research

Merkel Cell Carcinoma: Updates on Pathogenesis, Diagnosis, and Management
AbstractPurpose of ReviewTo describe updates on the pathogenesis, diagnosis, and management of Merkel cell carcinoma (MCC).Recent FindingsSequencing studies revealed that MCCs have either a low mutational burden and integrated Merkel cell polyomavirus (MCPyV), or they have a high number of ultraviolet-associated somatic mutations and no MCPyV. Clinically, prognosis was better for stage III MCC of unknown primary than known primary. Similarly, lack of immunosuppression conferred better prognosis. The immunogenicity of MCC was reflected in high response rates to PD-1/PD-L1 checkpoint inhibitors.SummaryMCC is a rare but aggre...
Source: Current Dermatology Reports - September 1, 2018 Category: Dermatology Source Type: research

Urticaria, Urticarial Vasculitis, Angioedema, and Related Diseases
AbstractPurpose of ReviewDermatologists are frequently called to evaluate patients with urticaria in the emergency room, urgent care clinics, and hospitals. Many acute urticarial eruptions will resolve without long-term sequelae; however, there are red flags that clinicians must be aware of.Recent FindingsFirst-line treatment for acute urticaria is regular dose H1 antagonists; however, the dose can be increased up to fourfold for refractory disease. Short courses of corticosteroids should be avoided as rebound urticaria is common upon discontinuation. Urticarial vasculitis presents with persistent, atypical urticaria, burn...
Source: Current Dermatology Reports - September 1, 2018 Category: Dermatology Source Type: research

Merkel Cell Carcinoma: Updates on Pathogenesis, Diagnosis, and Management
AbstractPurpose of ReviewTo describe updates on the pathogenesis, diagnosis, and management of Merkel cell carcinoma (MCC).Recent FindingsSequencing studies revealed that MCCs have either a low mutational burden and integrated Merkel cell polyomavirus (MCPyV), or they have a high number of ultraviolet-associated somatic mutations and no MCPyV. Clinically, prognosis was better for stage III MCC of unknown primary than known primary. Similarly, lack of immunosuppression conferred better prognosis. The immunogenicity of MCC was reflected in high response rates to PD-1/PD-L1 checkpoint inhibitors.SummaryMCC is a rare but aggre...
Source: Current Dermatology Reports - July 26, 2018 Category: Dermatology Source Type: research

Iatrogenic Dermatoses in Hospitalized Patients
AbstractPurpose of ReviewHospitalized patients are at risk of skin injury from drugs and procedures. These complications carry a high risk of morbidity, mortality, and internal organ involvement. This review examines updates in the treatment of drug eruptions and diagnosis of newly reported iatrogenic skin injuries that accompany novel procedures.Recent FindingsDrug eruptions are a common cause of iatrogenic injury and they vary in presentation and severity. Recent research suggests that medications such as cyclosporine and etanercept may improve mortality in patients with epidermal necrosis although a randomized controlle...
Source: Current Dermatology Reports - July 21, 2018 Category: Dermatology Source Type: research

Pyoderma Gangrenosum: What Do We Know Now?
AbstractPurpose of ReviewTo summarize the recent literature on the pathophysiology, diagnosis, and treatment of pyoderma gangrenosum.Recent FindingsA complex interplay between both the innate and adaptive immune systems underlies the pathogenesis of pyoderma gangrenosum (PG). Diagnosis remains a challenge, as there is no gold standard test to confirm the presence of the disease. Efforts to establish diagnostic criteria based on clinical findings have recently been proposed. Definitive management strategies are also lacking; however, current trends in treatment have favored the use of immunosuppressive medications, wound ca...
Source: Current Dermatology Reports - July 16, 2018 Category: Dermatology Source Type: research

Leg Ulcers: Expanding the Differential
AbstractPurpose of ReviewCutaneous lower extremity ulcerations are major source of morbidity and mortality. It can be challenging to identify an underlying etiology. This review provides a systematic framework for generating a thoughtful differential diagnosis and workup approach. We also highlight recent discoveries in the pathophysiology and treatment approaches of leg ulceration.Recent FindingsVenous leg ulceration is being treated with a number of promising new modalities including pentoxifylline, statin therapy, topical timolol, connexin-43 peptide antagonists, photodynamic therapy, and punch grafting. The role of vit...
Source: Current Dermatology Reports - July 13, 2018 Category: Dermatology Source Type: research

Urticaria, Urticarial Vasculitis, Angioedema, and Related Diseases
AbstractPurpose of ReviewDermatologists are frequently called to evaluate patients with urticaria in the emergency room, urgent care clinics, and hospitals. Many acute urticarial eruptions will resolve without long-term sequelae; however, there are red flags that clinicians must be aware of.Recent FindingsFirst-line treatment for acute urticaria is regular dose H1 antagonists; however, the dose can be increased up to fourfold for refractory disease. Short courses of corticosteroids should be avoided as rebound urticaria is common upon discontinuation. Urticarial vasculitis presents with persistent, atypical urticaria, burn...
Source: Current Dermatology Reports - July 11, 2018 Category: Dermatology Source Type: research

Pain Management in Patients with Chronic Wounds
AbstractPurpose of ReviewChronic wounds are increasing in prevalence and are often associated with significant pain, which can have a major impact on quality of life. Safe and effective pain management can be challenging, an unfortunate reality that is highlighted by the ongoing opioid crisis. This review aims to provide an evidence-based framework for pharmacologic and non-pharmacologic pain management in patients with chronic wounds.Recent FindingsAs reflected in the new CDC guidelines, no study has shown that long-term opioid use mitigates chronic pain. Non-pharmacologic therapies, including virtual reality and acupunct...
Source: Current Dermatology Reports - July 2, 2018 Category: Dermatology Source Type: research

Livedoid Vasculopathy: an Updated Review
AbstractPurpose of ReviewTo highlight the most recent findings in the literature on livedoid vasculopathy while providing a basic review of the disease.Recent FindingsLipoprotein(a) and plasminogen activator inhibitor continue to develop evidence supporting their involvement in the pathogenesis of livedoid vasculopathy. Systematic review of the literature has revealed that anticoagulants are the most commonly reported treatments in case series followed by anabolic steroids, antiplatelets, and intravenous immunoglobulins. No randomized or controlled trials have been performed studying treatment efficacy.SummaryThe literatur...
Source: Current Dermatology Reports - July 2, 2018 Category: Dermatology Source Type: research

Confocal Microscopy in Skin Cancer
This article provides an overview of strengths and limitations of non-invasive RCM in skin cancer diagnosis.Recent FindingsRCM features of common melanocytic and non-melanocytic skin neoplasms such as melanoma, actinic keratosis/squamous cell carcinoma, basal cell carcinoma, and nevi have been well defined and show good correlation with dermoscopic and histopathologic findings. Due to its technical properties, RCM is especially suitable for the examination of flat skin lesions.SummaryIn vivo RCM has been shown to increase the accuracy of non-invasive diagnosis of common skin neoplasms and is a valuable adjunct to dermoscop...
Source: Current Dermatology Reports - June 1, 2018 Category: Dermatology Source Type: research