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Seminars in Cutaneous Medicine and Surgery

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https://www.readbyqxmd.com/read/28895960/atopic-dermatitis-therapeutic-care-delivery-therapeutic-education-shared-decision-making-and-access-to-care
#1
Jennifer LeBovidge, Jenna Borok, Jeremy Udkoff, Gil Yosipovitch, Lawrence F Eichenfield
Atopic dermatitis (AD) is a chronic skin condition affecting children and adults, with a significant negative impact on patient and caregiver quality of life (QOL). Although effective treatments for AD are available, outcomes are often limited by poor adherence to treatment plans. Effective patient and caregiver education about the disease and its management is a necessary and important component of AD care. Therapeutic patient education (TPE) is a patient-centered process that aims to transfer information and skills necessary to manage and cope with a disease from health care professionals to patients and caregivers...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895959/atopic-dermatitis-emerging-therapies
#2
Eric Simpson, Jeremy Udkoff, Jenna Borok, Wynnis Tom, Lisa Beck, Lawrence F Eichenfield
Crisaborole and dupilumab represent the first 2 Food and Drug Administration (FDA)-approved therapies for atopic dermatitis (AD) in more than 15 years, and there are many promising drugs currently in development. This new wave of therapeutics capitalizes on the large body of work clarifying the pathogenesis of AD over the last several decades. In particular, type 2 cytokine-driven inflammation and skin barrier dysfunction are key processes underlying AD pathogenesis.
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895958/atopic-dermatitis-phototherapy-and-systemic-therapy
#3
Dawn Marie Davis, Jenna Borok, Jeremy Udkoff, Peter Lio, Jonathan Spergel
The majority of atopic dermatitis (AD) patients respond satisfactorily to gentle bathing, frequent moisturizing, and topical medications. Second-line therapies for AD should be used in recalcitrant cases or in patients with uncontrolled disease despite compliance with first-line measures and avoidance of allergens. Recommended advanced therapies include phototherapy, especially narrowband ultraviolet B, systemic immunosuppressants, and a new biologic agent. Few studies have compared head-to-head efficacy of the different immunosuppressant therapies such as cyclosporine, methotrexate, azathioprine and mycophenolate mofetil...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895957/atopic-dermatitis-addressing-allergy-infection-itch-and-complementary-therapies
#4
Jusleen Ahluwalia, Dawn Marie Davis, Sharon Jacob, Andrea Waldman, Peter Y Ong, Stuart Cohen, Adam Friedman, Peter Lio, Nathan Jetter, Jeffrey Bienstock, Jennifer LeBovidge, Jonathan Spergel, Luz Fonacier
Atopic dermatitis (AD) is a complex condition that results from the dynamic interplay between genetic predisposition, skin barrier defects, environmental factors, and a dysfunctional immune system. As a result, AD can be complicated by irritant and allergic contact dermatitis and imbalances in the skin microbiome, which can subsequently exacerbate the severity and complicate the course of preexisting atopic disease. Itch is an important symptom of AD, as it plays a large role in the quality of life of patients and their families...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895956/atopic-dermatitis-skin-care-and-topical-therapies
#5
David M Fleischer, Jeremy Udkoff, Jenna Borok, Adam Friedman, Noreen Nicol, Jeffrey Bienstock, Peter Lio, Megha M Tollefson, Lawrence F Eichenfield
Atopic dermatitis (AD) pathogenesis is strongly influenced by Type 2 innate lymphoid cell and T-helper cell type 2 lymphocyte-driven inflammation and skin barrier dysfunction. AD therapies attempt to correct this pathology, and guidelines suggest suggest basics of AD therapy, which include repair of the skin barrier through bathing practices and moisturizers, infection control, and further lifestyle modifications to avoid and reduce AD triggers.While some patients' AD may be controlled using these measures, inflammatory eczema including acute flares and maintenance therapy in more severe patients are treated with topical pharmacologic agents such as topical corticosteroids, topical calcineurin inhibitors, and, more recently, topical PDE-4 inhibitors...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895955/atopic-dermatitis-pathogenesis
#6
Emma Guttman-Yassky, Andrea Waldman, Jusleen Ahluwalia, Peck Y Ong, Lawrence F Eichenfield
Atopic Dermatitis (AD) is a complex inflammatory cutaneous disorder characterized by immune mediated inflammation and epidermal barrier dysfunction. Arising from a complex interplay between environmental and genetic factors, the definitive etiology of AD is perplexing and controversial. Advances in molecular medicine are radically transforming our understanding of AD pathogenesis. Increasing knowledge on the pathogenesis of AD results in novel therapeutic targets and pathways. This article details the pathogenesis section of the Curriculum United for Better Eczema Care (CUBE-C), facilitating primary care and sub-specialist education on the scientific advances driving recent AD therapeutic innovations...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895954/diagnosis-comorbidity-and-psychosocial-impact-of-atopic-dermatitis
#7
Dawn Marie Davis, Andrea Waldman, Sharon Jacob, Jennifer LeBovidge, Jusleen Ahluwalia, Megha Tollefson, Nathan Jetter, Jonathan Spergel
Atopic dermatitis (AD) is a chronic inflammatory skin disease, with a remitting relapsing course. The central diagnostic features of AD include pruritus, xerosis, eczematous lesions with a characteristic morphology and distribution, and a personal or family history of atopic disease. Several clinical studies have emphasized the link between AD and other atopic disorders including asthma, allergic rhinitis, and food allergies. More recent studies indicate possible links between AD and other nonatopic disorders, including ADHD, sleep disturbance, and mental health disorders, suggesting an even more profound impact of this disease...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28895953/curriculum-united-for-better-eczema-care-why-how-and-what
#8
Lawrence F Eichenfield, Jusleen Ahluwalia, Dawn Marie Davis, David M Fleischer, Andrea Waldman, Jonathan Spergel
While various medical specialties treat eczema patients, care for these patients is largely fragmented and disorganized. Moreover, standardized treatment protocols that incorporate upcoming eczema therapies and emerging guidelines have yet to be established. Thus, there is both a need and an opportunity to equip clinicians to succeed in this novel and changing era of eczema care. The National Eczema Association's (NEA) strategic plan-developed through extensive discussions with patients who have atopic dermatitis and their caregivers, industry, and providers representing different specialties-called for the creation of an interdisciplinary coalition to steer this initiative...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28745729/highlights-of-skin-disease-education-foundation-s-41st-annual-hawaii-dermatology-seminar%C3%A2
#9
Kenneth B Gordon, Craig L Leonardi, Daniel E Furst, Neal Bhatia, Lawrence F Eichenfield, Katie Beleznay
New therapies, recent pathophysiological findings, and updated guidelines combined to create compelling presentations at the Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminarâ„¢. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. A growing understanding of the biology of psoriasis has facilitated the development of increasingly efficacious medications. Skin clearance used to be regarded as an impractical goal for psoriasis therapy...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538750/major-gaps-in-understanding-and-treatment-of-hidradenitis-suppurativa
#10
Lauren K Hoffman, Mondana H Ghias, Amit Garg, Iltefat H Hamzavi, Afsaneh Alavi, Michelle A Lowes
Hidradenitis suppurativa (HS) is a complex dermatological disease characterized by recurrent painful nodules and suppuration in areas such as the axilla and groin. The disease is poorly understood and treatment is not satisfactory. In October 2016, the Canadian and United States Hidradenitis Suppurativa Foundations organized the inaugural Symposium on Hidradenitis Suppurativa Advances (SHSA) in Toronto, Canada. This meeting brought together experts from Canada, the United States, and Europe to discuss the latest advances in HS...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538749/complications-of-hidradenitis-suppurativa
#11
Joyce T Yuan, Haley B Naik
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent painful nodules and abscesses involving intertriginous areas. Repeated episodes of profound inflammation in HS can lead to a number of complications, causing significant morbidity and decreasing quality of life. Complications of HS may affect the skin alone or may have systemic impact. Cutaneous complications of HS include sinus tracts, fistulae, scarring and contractures, squamous cell carcinoma, and lymphedema...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538748/quality-of-life-considerations-and-pain-management-in-hidradenitis-suppurativa
#12
Gregor Be Jemec
All skin diseases involve some element of stigmatization and psychosocial consequence for the individual patient, but few, if any, skin diseases can match the impact of hidradenitis suppurativa (HS) on the patient. The inflamed lesions progressing to noninflamed nodules and abscesses are not only perceived as unclean and stigmatizing by the patients, but also cause pain and scarring making this inflammatory skin disorder unique. It is obvious that the disease has a significant negative impact on the patients' quality of life (QOL)...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538747/a-retrospective-review-of-light-and-laser-based-management-of-hidradenitis-suppurativa
#13
Melissa A Levoska, Cynthia L Nicholson, Iltefat H Hamzavi
Hidradenitis suppurativa (HS) is a chronic skin disease that is difficult to manage and often refractory to medical management. Light and laser therapies have been utilized in the field of dermatology to treat a variety of skin conditions, but more recently were studied in the management of HS. Usually performed as outpatient procedures with a low risk of complications, they offer several advantages to traditional cold knife surgical procedures. We reviewed the various light- and laser-based treatments studied in HS and compared their efficacy...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538746/medical-management-of-hidradenitis-suppurativa
#14
Lauren Av Orenstein, Robert G Micheletti
Hidradenitis suppurativa is a chronic inflammatory disease of the folliculo-infundibular unit for which no individual treatment is uniformly effective. A wide array of therapies has been reported successful in the treatment of hidradenitis, although few high-quality clinical trials have been conducted. Comparing the effectiveness of different therapies has proven challenging due to heterogeneity and limited validation of outcome measures. We performed a systematic review of clinical trials of medical treatments for hidradenitis, yielding 8 articles reporting on 9 trials of antibiotic, hormonal, and biologic therapies...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538745/topical-management-and-wound-care-approaches-for-hidradenitis-suppurativa
#15
Camila Antia, Afsaneh Alavi, Ali Alikhan
Hidradenitis suppurativa (HS) is a chronic inflammatory disease that affects the follicular unit in apocrine glandbearing skin, resulting in deep-seated nodules, sinus tracts, abscesses, and ultimately scarring. HS is a highly distressing condition, and has one of the highest impacts on quality of life compared to other dermatologic diseases. Various topical therapies have been described that may be used alone or in conjunction with systemic or physical modalities for HS. Additionally, proper wound care is essential to the successful management of HS, particularly given the suppurative nature of the disease...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538744/comorbidities-of-hidradenitis-suppurativa
#16
Martina L Porter, Alexa B Kimball
Hidradenitis suppurativa (HS) is an inflammatory skin disorder with many associated comorbidities, including obesity, metabolic syndrome, smoking, depression, arthritis, autoinflammatory syndromes, inflammatory bowel disease, and genetic syndromes. In addition, HS patients can suffer from a variety of diseases related to the chronic inflammatory nature of their HS such as cardiovascular disease and anemia. An understanding of these comorbidities and associations is essential for the management of HS, and routine screening for these entities should be considered in all HS patients...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538743/pathophysiology-of-hidradenitis-suppurativa
#17
Lauren K Hoffman, Mondana H Ghias, Michelle A Lowes
The pathophysiology of hidradenitis suppurativa (HS) is not well understood. Some of our knowledge comes from clinical and epidemiological observations, along with studies of the histopathology and immunohistochemistry of affected skin. More recently, cutaneous molecular studies and transcriptomic analyses have provided additional information regarding inflammatory processes. The chronic cutaneous inflammation, systemic symptoms, and associated comorbidities suggest that HS should be classified as an immune-mediated disease, rather than a primary infectious disease...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538742/epidemiologic-and-clinical-features-of-hidradenitis-suppurativa
#18
Isha Parulkar, Heba Haleem, So Yeon Paek
Hidradenitis suppurativa (HS) is an inflammatory condition characterized by recurrent abscesses which may result in sinus tracts and dermal scarring. This article reviews current epidemiologic data on HS in diverse populations, including prevalence based on geography, age, gender, ethnicity, and details the spectrum of clinical features of hidradenitis suppurativa with discussion of disease severity and risk factors. Recently proposed HS diagnostic criteria are also presented.
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28538741/hidradenitis-suppurativa-introduction
#19
Haley B Naik
Hidradenitis suppurativa (HS) is a prevalent and devastating inflammatory skin disease predominating in women and minorities. HS is characterized by painful recurrent abscesses, foul-smelling purulent drainage, sinus tract and fistula formation, and disfiguring scarring involving intertriginous body sites including the axillae, breasts, groin, and buttocks. Disease onset typically occurs in the second to fourth decades of life and is associated with significant impacts on physical and psychological well-being due to pain, shame, and isolation, leading to profound suffering and despair...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28654711/addressing-the-immunopathogenesis-of-atopic-dermatitis-advances-in-topical-and-systemic-treatment
#20
REVIEW
Lawrence F Eichenfield, Linda F Stein Gold
Several immunologic mediators-phosphodiesterase (PDE), interleukin (IL), small molecules, and Janus kinase-have been implicated in the pathogenesis of atopic dermatitis, and evidence has shown that blocking these mediators can help modify the disease process. Several new topical medications have been developed that target the enzyme PDE; crisaborole was recently approved by the US Food and Drug Administration (FDA) for the treatment of atopic dermatitis, and phase II studies have been completed on OPA-15406...
March 2017: Seminars in Cutaneous Medicine and Surgery
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