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British Journal of Dermatology

D Kopasker, A Kwiatkowski, R N Matin, C A Harwood, F Ismail, J T Lear, J Thomson, Z Hasan, G N Wali, A Milligan, L Crawford, I Ahmed, H Duffy, C M Proby, P F Allanson
BACKGROUND: Treatment of actinic keratoses (AK) is a potentially effective strategy for prevention of cutaneous squamous cell carcinoma (cSCC). However, the patient perspective on potential benefits of AK treatment in terms of skin cancer reduction has received little attention to date. OBJECTIVES: (1) To investigate patient preferences for AK topical treatments using a discrete choice experiment (DCE); (2) To evaluate patient willingness to trade between clinical benefit and medical burden...
May 21, 2018: British Journal of Dermatology
F Valenzuela, N J Korman, R Bissonnette, N Bakos, T-F Tsai, M K Harper, W C Ports, H Tan, A Tallman, H Valdez, A C Gardner
BACKGROUND: Tofacitinib is an oral Janus kinase inhibitor. Final safety and efficacy data from an open-label extension study of tofacitinib in psoriasis are reported. OBJECTIVE: To evaluate the long-term safety and durability of efficacy of tofacitinib in adults with moderate to severe chronic plaque psoriasis. METHODS: Eligible patients who completed qualifying Phase 2/3 tofacitinib studies received tofacitinib 10 mg twice daily (BID) until Month 3; subsequently, the dose could be adjusted by investigators to either 5 or 10 mg BID...
May 21, 2018: British Journal of Dermatology
V K Yenamandra, P C van den Akker, H H Lemmink, S Z Jan, G F H Diercks, M Vermeer, M P van den Berg, P van der Meer, A M G Pasmooij, R J Sinke, M F Jonkman, M C Bolling
Dominant mutations in the KLHL24 gene, encoding for kelch-like protein 24, have been implicated in the pathogenesis of epidermolysis bullosa simplex (EBS). So far, 26 patients from different ethnicities have been reported and all of them harboured a heterozygous KLHL24 start-codon mutation, with c.1A>G;p.Met1? being the most prevalent.1-3 Through this report, we aimed to expand the phenotypic spectrum by incorporating additional findings, in particular, dilated cardiomyopathy, seen in a Dutch family. This article is protected by copyright...
May 19, 2018: British Journal of Dermatology
G Harrop, R S Dawe, S Ibbotson
Erythemal episodes during phototherapy can be painful, limit efficacy due to premature discontinuation of treatment and may contribute to chronic cutaneous damage. Many patients receiving phototherapy take photosensitive medications. Stern et al., investigated 1,125 patients receiving maintenance psoralen-ultraviolet A photochemotherapy (PUVA) for psoriasis and did not detect a significant difference in risk of erythemal episodes between those receiving photosensitising medication compared with those who were not1 ...
May 19, 2018: British Journal of Dermatology
R Browne, L Stewart, H C Williams
AIM: To assess the effects of methotrexate for maintaining hair regrowth in alopecia totalis. METHODS: We critically appraised the literature identified from searching PubMed, Ovid MEDLINE, Ovid Embase and Cochrane Central (October 2017), using the search terms ("alopecia areata" OR "alopecia totalis" OR "alopecia universalis") AND (methotrexate). RESULTS: Two prospective studies and 11 retrospective case series were included comprising 226 patients with alopecia varying from 30% hair loss to alopecia universalis at baseline...
May 19, 2018: British Journal of Dermatology
F Brunet-Possenti, C Charpentier, G Collin, D Descamps, V Descamps
Human papillomavirus (HPV) infection has been a subject of interest for decades, notably because of the high burden of HPV-related diseases1 . High-risk HPVs (HR-HPV) are responsible for virtually all cases of cervical cancer and are also implicated in other mucosal cancers especially those located in the anal and oropharyngeal areas. Low-risk HPVs (LR-HPV) can induce cutaneous or anogenital warts, usually treated with cryotherapy, CO2 laser vaporization, topical application of salicylic acid or imiquimod...
May 19, 2018: British Journal of Dermatology
L Solman, M Glover, P E Beattie, H Buckley, S Clark, J E Gach, A Giardini, I Helbling, R J Hewitt, B Laguda, S M Langan, A E Martinez, R Murphy, L Proudfoot, J Ravenscroft, H Shahidullah, L Shaw, S B Syed, L Wells, C Flohr
BACKGROUND: Infantile haemangiomas (IH) are the most common vascular tumours of infancy. Despite their frequency and potential complications, there are currently no unified UK guidelines for the treatment of IH with propranolol. There are still uncertainties and diverse opinions regarding indications, pre-treatment investigations, its use in PHACES syndrome, and cessation of treatment. METHODS: This study used a modified Delphi technique, which involved an international treatment survey, a systematic evidence review of the literature, a face-to-face multidisciplinary panel meeting and anonymous voting...
May 17, 2018: British Journal of Dermatology
I H Yusuf, A J Lotery, M R Ardern-Jones
Hydroxychloroquine has become established in the management of various forms of cutaneous lupus, photosensitive dermatoses, porphyria cutanea tarda, cutaneous sarcoid, lichen planus and other inflammatory dermatological diseases.1 Dermatologists who prescribe hydroxychloroquine should be aware of new recommendations for retinal screening in all patients on long-term hydroxychloroquine and chloroquine in the United Kingdom.2 The recommendations have been published by the Royal College of Ophthalmologists following a systematic review of the current evidence with input from representatives from the British Society for Rheumatology (BSR)3 and the British Association of Dermatologists (BAD) (Dr...
May 16, 2018: British Journal of Dermatology
M T Wan, M E Ming
AIM: To show whether either nivolumab in combination with ipilimumab or nivolumab monotherapy vs. ipilimumab monotherapy extends overall survival (OS) or progression-free survival (PFS) in adults with previously untreated, advanced melanoma. SETTING AND DESIGN: The trial was conducted at 137 sites in 21 countries. Randomization (n = 945; 1 : 1 : 1 ratio) was stratified according to metastasis stage, BRAF mutation status and programmed death ligand 1 status. STUDY EXPOSURE: Adults were randomized to one of the following: nivolumab plus ipilimumab every 3 weeks for four doses, followed by nivolumab every 2 weeks; nivolumab every 2 weeks plus placebo; or ipilimumab every 3 weeks for four doses plus placebo...
May 15, 2018: British Journal of Dermatology
L Christensen, K Cooper, K Honda, D Mansur
The European Organization for Research and Treatment of Cancer (EORTC) and the World Health Organization (WHO) classification system describes three main types of primary cutaneous B cell lymphomas: primary cutaneous follicle center lymphoma (PCFCL), primary cutaneous marginal zone lymphoma (PCMZL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL, LT). Prognosis for PCFCL and PCMZL is excellent, with 5 year survival rates between 90% and 100% for both types. PCLBCL, LT on the other hand, has a worse prognosis with 5 year survival rates of 45%-50%...
May 15, 2018: British Journal of Dermatology
L A A Gerbens, C J Apfelbacher, A D Irvine, S Barbarot, R J de Booij, A E Boyce, M Deleuran, L F Eichenfield, M H Hof, M A Middelkamp-Hup, A Roberts, J Schmitt, C Vestergaard, D Wall, S Weidinger, P R Williamson, C Flohr, P I Spuls
BACKGROUND: Evidence of immunomodulatory therapies to guide clinical management for atopic eczema (AE) is scarce, despite frequent and often off-label use. Patient registries provide valuable evidence for the effects of treatments under real world conditions which can inform treatment guidelines, give the opportunity for health economic evaluation and the evaluation of quality of care, as well as pharmacogenetic and -dynamic research which cannot be adequately addressed in clinical trials...
May 15, 2018: British Journal of Dermatology
T H Zhu, T R Zhu, K A Tran, R K Sivamani, V Y Shi
Atopic dermatitis is a systemic disorder characterized by abnormal barrier function across multiple organ sites. Initial disruption in the skin epidermal barrier permits allergen sensitization and colonization by pathogens. This induces TH 2 inflammatory response and a thymic stromal lymphopoietin mediated pathway that further promotes barrier breakdown at distant sites including the intestinal and respiratory tract. Clinically, atopic dermatitis can progress from skin disease to food allergy, allergic rhinitis, and later asthma, a phenomenon commonly known as the atopic march...
May 15, 2018: British Journal of Dermatology
A Cayuela, L Cayuela, S Rodríguez-Domínguez, A I Lorente, M Rodríguez de la Borbolla
Although melanoma mortality rates levelled off in several regions in the 1980s-1990s, and even decreased in other, recent studies found that mortality rates of melanoma are now increasing in Southern Europe. Melanoma mortality rate in Spain (1975-2001) increased. Examination of the mortality trends by age group and birth cohort revealed less rapidly rising (men) or stabilizing (women) age-adjusted melanoma mortality rates because of declining mortality in the younger age groups and more recent birth cohorts...
May 14, 2018: British Journal of Dermatology
S M Pilkington, R J Dearman, I Kimber, C E M Griffiths
Ageing and immunosenescence are associated with an increased susceptibility to skin infections and skin cancers. Epidermal Langerhans cells (LC) survey the skin microenvironment for pathogens and tumour cells and migrate to lymph nodes to present antigen. In humans there are fewer epidermal LC in aged as compared with young skin and their migration is reduced in response to trauma and tumour necrosis factor (TNF)-α. We have also shown that interleukin (IL)-1β gene expression is reduced in aged skin and that LC migration is restored by exogenous IL-1β...
May 14, 2018: British Journal of Dermatology
M C Issa, S P Torreão, M Boechat, R Luiz
SIR, we evaluated whether laser-assisted drug delivery (LADD) of onabotulinumtoxinA using combined fractional ablative laser with impact ultrasound was capable of reducing palmar sweat production. Palmar hyperhidrosis is a common disorder with substantial negative impact on quality of life. Palliative non-surgical treatments include antiperspirants, iontophoresis, oral anticholinergic drugs, and intradermal injection of botulinum toxin (BTX). Antiperspirants, although convenient, require repeated applications and cause skin irritations...
May 14, 2018: British Journal of Dermatology
N M Golbari, S J Lockwood, M L Porter, A B Kimball
While recent advances in psoriasis treatment have improved achievable efficacy levels, with regimens achieving PASI 90 response, 9-30% of severe psoriasis patients and almost 50% of mild patients do not receive treatment. The Health Belief Model (HBM), designed in 1952, uses patient perspectives to predict preventive health behavior and has been used to help elucidate patient engagement in health promoting behaviour, including treatment seeking and barriers to psoriasis care. This article is protected by copyright...
May 14, 2018: British Journal of Dermatology
V Haug, V Behle, S Benoit, H Kneitz, B Schilling, M Goebeler, A Gesierich
the anti-programmed death-1 (PD-1) antibody pembrolizumab, routinely used for treatment of metastatic melanoma or non-small cell lung cancer, was recently shown to have clinical meaningful activity in metastatic Merkel cell carcinoma (MCC). Several cases of bullous pemphigoid (BP) induced by PD-1 antibodies in melanoma have been reported so far. Here we report a case of oral mucous membrane pemphigoid (MMP) - a previously unknown, severe immune-related adverse event (irAE) occurring during pembrolizumab therapy...
May 14, 2018: British Journal of Dermatology
S Moawad, M Reigneau, A de la Fouchardière, N Soufir, J-L Schmutz, F Granel-Brocard, A Phan, A-C Bursztejn
BRCA1 associated protein (BAP)1-inactivated melanocytic nevus/tumours (BIMN/Ts) are specific skin tumours that appear during the first two decades of life. These lesions must be recognized by dermatologists and pathologists as an early predictive marker of BAP1 cancer syndrome, as they may precede the development of uveal and cutaneous melanomas, mesotheliomas, lung adenocarcinomas, renal cell carcinomas, and meningiomas by several years. The dermoscopic characteristics of these tumours have not been described...
May 13, 2018: British Journal of Dermatology
H Salameh, H Sarairah, M Rizwan, Y-F Kuo, K E Anderson, A K Singal
INTRODUCTION: Porphyria cutanea tarda (PCT), the most common human porphyria, due to hepatic deficiency of uroporphyrinogen decarboxylase (UROD) activity, which is acquired in the presence of multiple susceptibility factors. PCT presents clinically with cutaneous blistering photosensitivity and is readily treatable with either repeated phlebotomy or 4-aminoquinoline antimalarial. We performed a systematic review and meta-analysis to compare the effectiveness of these quite different treatment approaches, especially on relapse rates after achieving remission...
May 11, 2018: British Journal of Dermatology
C B Ho, K Hsieh, W Y Chen, Y T Lin, J F Chiou, H L Lee, H S Shiah
Spindle cell haemangioma (SCH), formerly known as spindle cell haemangioendothelioma, is a rare benign vascular tumour characterised by reactive vascular proliferation.1 The lesions mostly occur in the dermis and subcutaneous tissue of distal extremities. SCH is more common in children and young adults than other age groups, and it is equally prevalent in the sexes. Histologically, proliferating spindle cells and cavernous blood vessels constitute the structure of SCH. SCH can present as vascular tumours in Maffucci's syndrome (MS)...
May 11, 2018: British Journal of Dermatology
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