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British Journal of Dermatology

C H Smith, Z K Jabbar-Lopez, Z Z Yiu, T Bale, A D Burden, L C Coates, M Cruickshank, T Hadoke, E MacMahon, R Murphy, C Nelson-Piercy, C M Owen, R Parslew, E Peleva, E Pottinger, E J Samarasekera, J Stoddart, C Strudwicke, V Venning, R B Warren, L S Exton, M F Mohd Mustapa
The overall aim of the guideline is to provide evidence-based recommendations on the use of biologic therapies (adalimumab, etanercept, infliximab, ixekizumab, secukinumab and ustekinumab) in adults, children and young people for the treatment of psoriasis; consideration is given to the specific needs of people with psoriasis and psoriatic arthritis. Biologic therapies have now been in use for over 10 years, and with accrued patient-years exposure and clinical experience, many areas that were covered in previous versions of the guideline are now part of the Summary of Product Characteristics (SPC) and/or routine care so that specific recommendations are redundant (see Toolkit A: Summary of licensed indications and posology for biologic therapy, in Supporting information 2)...
May 17, 2017: British Journal of Dermatology
P Rodríguez-Jiménez, P Chicharro, A Godoy, M Llamas-Velasco, M García, E Daudén
Ustekinumab is a human monoclonal antibody directed against the p40 subunit of both interleukin (IL)-12 and IL-23(1) . It has shown to be very effective in the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis with a good safety profile(2,) .In the last ten years, the appearance of antinuclear antibodies (ANA) and the induction of autoimmune diseases during treatment with tumour necrosis factor-alpha (TNFα) inhibitors has been described (3-4) . This article is protected by copyright...
May 16, 2017: British Journal of Dermatology
S Khan, M Ansar, A Kamal Khan, K Shah, N Muhammad, S Shahzad, D A Nickerson, M J Bamshad, R L P Santos-Cortez, S M Leal, W Ahmad
Developmental nail disorders are heterogeneous group of genodermatosis, with nonsyndromic congenital nail disorder (NDNC) being a rare subgroup inherited in autosomal dominant or autosomal recessive pattern. These are classified into ten different types (NDNC1-10), which are described in OMIM.(1) The genes described for isolated nail disorders include PLCD1 (MIM 602142), RSPO4 (MIM 610573), FZD6 (MIM 603409), COL7A1 (MIM 120120), HPGD (MIM 601688) and SLCO2A1 (MIM 601460). In Addition, two other loci for NDNC have been mapped on chromosome 17p13 and 17q25...
May 15, 2017: British Journal of Dermatology
A Spencer, P Gazzani, R Gadvi, S J Hughes, A Stevens, F Shah, J Scarisbrick
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma (CTCL), accounting for 55% cases(1) . Although incurable, it most often presents in early-stage with a good prognosis. The primary aim is to minimise symptoms and maximise quality of life. The UK British Association of Dermatologists 2003 guidelines recommend a staging computed tomography (CT) scan of the neck, thorax, abdomen and pelvis for patients with stage IIA and above(2) . This article is protected by copyright. All rights reserved...
May 12, 2017: British Journal of Dermatology
C Cassius, P Moguelet, J B Monfort, H Fessi, P A Michel, G Boulahia, K Cury, C Frances, P Senet
Calciphylaxis or calcific uremia arteriopathy (CUA) is a rare and highly morbid condition that predominantly affects dialyzed end-stage renal disease (ESRD) patients(1) . One-year survival rate is estimated to be 40-50%, with sepsis emerging as the leading cause of death (2) . Calciphylaxis presents with painful necrotic cutaneous ulcers, livedo racemosa, hemorrhagic patches, indurated plaques, or hemorrhagic bullae predominantly on the proximal lower extremities and trunk (2) . This article is protected by copyright...
May 12, 2017: British Journal of Dermatology
S Kumar, D De, S Handa, R K Ratho, S Bhandari, A Pal, P Kamboj, S Sarkar
BACKGROUND: Oral mucosal lesions of pemphigus vulgaris (PV) are known to show more treatment refractoriness than skin lesions. OBJECTIVES: To identify the role of different clinical and laboratory parameters in the treatment refractoriness in the oral lesions of PV. METHODS: This prospective study recruited 50 adult patients of PV having oral lesions. Patients were given treatment appropriate for overall disease severity. Treatment refractoriness was defined arbitrarily as less than 75% reduction in oral objective Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) after treatment for 6 months...
May 12, 2017: British Journal of Dermatology
P Gisondi, L Bianchi, A Conti, P Dapavo, P Malagoli, S Piaserico, F Savoia, F Prignano, G Girolomoni
Infliximab is a chimeric human-murine monoclonal antibody that is very effective in chronic plaque psoriasis reaching a Psoriasis Area and Severity Index (PASI) 75 response in 80.4% of patients at week 10.(1) The more common adverse events include infusion reactions and upper respiratory tract infections.(2) The European Medicines Agency has approved the use of infliximab biosimilar CT-P13 for psoriasis by extrapolating efficacy from studies in rheumatoid arthritis and ankylosing spondilytis.(3,4) This article is protected by copyright...
May 12, 2017: British Journal of Dermatology
S Cazzaniga, C Apfelbacher, T Diepgen, R Ofenloch, E Weisshaar, S Molin, A Bauer, V Mahler, P Elsner, J Schmitt, B K Ballmer-Weber, P Spring, L Naldi, L Borradori, D Simon
BACKGROUND: Hand eczema (HE) has a high incidence and prevalence, and is associated with disturbances of both physical and psychological well-being, and risk of persistence as chronic HE (CHE). Epidemiological studies on HE provided mainly descriptive and risk analyses, but pattern analyses of variables associated with HE, in particular CHE have not been explored so far. OBJECTIVES: To investigate and display the semantics of associations among variables of HE obtained by the Swiss and German registries of CHE (CARPE) to dissect patterns and novel links...
May 12, 2017: British Journal of Dermatology
A Blauvelt, K Reich, R B Warren, J C Szepietowski, B Sigurgeirsson, S K Tyring, I Messina, V Bhosekar, J Oliver, C Papavassilis, J Frueh, R G B Langley
Clinical trials of biologic therapies in psoriasis usually evaluate fixed dosing regimens. It is well-known, however, that patients prescribed biologics may occasionally need to interrupt therapy for reasons such as surgery, changes in healthcare coverage, or pregnancy.(1) Consequently, dermatologists need to know whether interruption of biologic therapy may be associated with diminished response upon retreatment. We analyzed data from a randomised withdrawal trial of secukinumab in subjects with moderate to severe plaque psoriasis to ascertain the effects of retreatment...
May 12, 2017: British Journal of Dermatology
C Wlodek, C M Penfold, J F Bourke, M M U Chowdhury, S M Cooper, S Ghaffar, C Green, C R Holden, G A Johnston, A A Mughal, C Reckling, R A Sabroe, N M Stone, D Thompson, S M Wilkinson, D A Buckley
BACKGROUND: There is a significant rate of sensitisation worldwide to the oxidised fragrance terpenes limonene and linalool. Patch testing to oxidised terpenes is not routinely carried out; the ideal patch test concentration is unknown. OBJECTIVES: To determine the best test concentrations for limonene and linalool hydroperoxides, added to the British baseline patch test series, to optimise detection of true allergy and minimise irritant reactions. METHODS: During 2013-2014, 4563 consecutive patients in 12 UK centres were tested to hydroperoxides of limonene in petrolatum (pet...
May 11, 2017: British Journal of Dermatology
X H Yuan, Z H Jin
Melanocytes are generally characterized by the basic ability of melanin synthesis and transfer to adjacent keratinocytes to constitute individual skin phenotype and provide epidermal protection from various stimuli, such as ultraviolet (UV) irradiation, through a complex process called melanogenesis, which can be regulated by autocrine or paracrine factors. Recent evidences have revealed the paracrine effects of keratinocytes on melanogenesis by secreting cytokines, including alpha-melanocyte stimulating hormone (α-MSH) and endothelin-1...
May 11, 2017: British Journal of Dermatology
M Sticherling, A Franke, E Aberer, R Gläser, M Hertl, C Pfeiffer, B Rzany, S Schneider, I Shimanovich, T Werfel, A Wilczek, D Zillikens, E Schmidt
BACKGROUND: Current treatment of bullous pemphigoid (BP) is based on the long-term use of topical and/or systemic corticosteroids associated with a high rate of adverse events and increased mortality. OBJECTIVE: To study the corticosteroid-sparing potential of azathioprine and dapsone. METHOD: A prospective, multicenter, randomized, non-blinded clinical trial that compares efficacy and safety of two parallel groups of BP patients treated with oral methylprednisolone 0...
May 11, 2017: British Journal of Dermatology
L Fornara, C Fornara, R Cananzi, D Lilleri, M Furione, V Brazzelli
psoriasis is a chronic inflammatory skin disease that affects approximately 2-3% of the world population.(1) Among the cytokines produced by T cells, TNF-α has a crucial role in psoriasis.(2) Thus, TNF-α blocking therapy is efficient in the treatment of psoriasis. This article is protected by copyright. All rights reserved.
May 11, 2017: British Journal of Dermatology
S C I Ip, D L Cottle, L K Jones, J M Weir, D P Kelsell, E A O'Toole, P J Meikle, I M Smyth
Harlequin Ichythosis (HI) is a severe skin disease caused by mutations in the lipid transport protein, ABCA12. This disrupts extracellular lipid deposition; limiting barrier function and resulting in the differentiation of a thickened, restrictive epidermis. This phenotype is at least partially recapitulated in mouse models of disease. While patients(1) (and HI mice(2) ) exhibit a partial phenotypic correction after birth, they still require a life-long regime of frequent bathing, mechanical desquamation and emollient application...
May 10, 2017: British Journal of Dermatology
R J Martin, M Arefi, M Splitt, L Redford, C Moss, N Rajan
Germline mutations in the oncogene HRAS cause syndromes with systemic and cutaneous features, notably Costello syndrome (CS).(1) Postzygotic activating mutations in HRAS are increasingly recognised as a cause of epidermal naevi which are sometimes associated with the extracutaneous features of germline rasopathies. Epidermal naevi caused by HRAS mutations present with varied morphology including sebaceous naevus, woolly hair naevus and phacomatosis pigmentokeratotica (PPK)(2) . This article is protected by copyright...
May 10, 2017: British Journal of Dermatology
R Chopra, P P Vakharia, R Sacotte, N Patel, S Immaneni, T White, R Kantor, D Y Hsu, J I Silverberg
BACKGROUND: Scoring systems for assessing the signs of atopic dermatitis (AD) are complex and difficult to interpret. Severity strata are helpful to properly interpret these assessments. We sought to confirm previously reported strata for Eczema Area and Severity Index (EASI), Scoring AD (SCORAD) and objective component of SCORAD (oSCORAD) and develop strata for the modified EASI (mEASI), Atopic Dermatitis Severity Index (ADSI) and body surface (BSA) for use in adults with AD. METHODS: Skin-examination was performed in 673 adolescents and adults (age ≥13 years) with diagnosed AD in a dermatology practice setting...
May 9, 2017: British Journal of Dermatology
J C Tapia, K Chavez, G Malaga, F Bravo
psoriasis is reported by the World Health Organization as a chronic skin disease with an elevated physical, emotional and socioeconomic burden. However, this burden is underestimated in developing countries, such as Peru, due the lack of epidemiological research in dermatology. This uncertainty hinders the development of appropriate patient-centered health care that prevent patients from unnecessary suffering. This article is protected by copyright. All rights reserved.
May 9, 2017: British Journal of Dermatology
M Tasani, P Ancliff, M Glover
Kaposiform haemangioendothelioma (KHE) and tufted angioma (TA) are rare vascular tumours that typically present during infancy or childhood. Originally regarded as distinct lesions, they are now considered as part of a spectrum. Presentation is usually as an enlarging, tender, blue or red mass. Both KHE and TA may be associated with Kasabach-Merritt Phenomenon (KMP), a severe haemorrhagic state arising from intralesional platelet trapping, microangiopathic haemolytic anaemia, and consumptive coagulopathy. This article is protected by copyright...
May 9, 2017: British Journal of Dermatology
A Helander, M Bradley, J Lapins
In a commentary to our publication entitled "Acute skin and hair symptoms followed by severe, delayed eye complications in subjects using the synthetic opioid MT-45",[1] Yip and Deng [2] argue that the lack of opioid symptoms would indicate involvement of another drug class, possibly arsenic or 2,4-dinitrophenol (DNP). In this respect, it should be emphasized that the patients did not seek hospital care for acute opioid overdose symptoms but for unexpected, late adverse side effects involving the skin, hair, and eyes...
May 8, 2017: British Journal of Dermatology
K S Thomas, R Brindle, J R Chalmers, B Gamble, N A Francis, D Hardy, J Hooper, V Keeley, N J Levell, M McPhee, L Metcalf, M Santer, M Tarpey, P Smart, A Wallace, S Wilkes
Priority setting partnerships give patients and heath care professionals an equal voice in driving priorities for future research. This ensures that research answers the most important questions that are needed to inform clinical practice(1) . Cellulitis (also known as erysipelas) is an acute infection of the skin and underlying tissue that often recurs. This article is protected by copyright. All rights reserved.
May 6, 2017: British Journal of Dermatology
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