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Skin Therapy Letter

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https://www.readbyqxmd.com/read/29772037/janus-kinase-inhibitors-a-review-of-their-emerging-applications-in-dermatology
#1
A Cinats, E Heck, L Robertson
The class of medications known as Janus kinase inhibitors block cytokine-mediated signaling via the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway, which plays an important role in immunoregulation and normal cell growth. This class includes the drugs tofacitinib, approved for the treatment of rheumatoid arthritis, and ruxolitinib, approved for the treatment of myelofibrosis and polycythemia rubra vera. The most common adverse events (AEs) reported in patients taking tofacitinib are infections, whereas the most common AEs in patients taking ruxolitinib are anemia and thrombocytopenia...
May 2018: Skin Therapy Letter
https://www.readbyqxmd.com/read/29772036/chronic-urticaria-following-practice-guidelines
#2
E P Westby, C Lynde, G Sussman
Histamine is a key inflammatory player in the pathogenesis of urticaria, a mast-cell-driven disease characterized clinically by the development of wheals, angioedema, or both. Changes to the management of chronic spontaneous urticaria have recently been adopted due to increasing literature surrounding the efficacy and safety of up-dosing modern second-generation H1 -antihistamines and the use of omalizamub, a biologic agent, as a third-line treatment. Given the prevalence of chronic urticaria and its impact on quality of life, this editorial aims to provide a summary of the proposed updated guidelines for the management of chronic urticaria as agreed upon at the 5th Consensus Conference on the Update and Revision of the EAACI/GA2 LEN/EDF/WAO Guideline for Urticaria in Berlin in December 2016...
May 2018: Skin Therapy Letter
https://www.readbyqxmd.com/read/29562089/a-review-of-fabry-disease
#3
B Chan, D N Adam
Fabry disease (FD) is an X-linked lysosomal storage disease. A lack of alpha-galactosidase activity results in the accumulation of globotriaosylceramide in cells of various systems, leading to multi-systemic effects. The cutaneous hallmark of FD is a specific distribution of angiokeratoma. Other common symptoms include cornea verticillata, acroparesthesia, and sweating abnormalities. FD-specific symptoms, history, as well as examination of angiokeratoma can assist in the differential diagnosis. Enzyme replacement therapy is the current mainstay of treatment...
March 2018: Skin Therapy Letter
https://www.readbyqxmd.com/read/29562088/brodalumab-a-review-of-safety
#4
S Rusta-Sallehy, M Gooderham, K Papp
Interleukin (IL)-17 is important in the pathophysiology of psoriasis and has proven to be an effective therapeutic target. Brodalumab, the third commercially available IL-17 antagonist, was approved by the US FDA in February 2017 for the treatment of moderate-tosevere plaque psoriasis. As brodalumab enters the marketplace, it is imperative to investigate its safety profile. We conducted a safety assessment of brodalumab using publically available adverse event data from phase II and III clinical trials. The most common adverse events were nasopharyngitis, upper respiratory tract infection, and candidiasis...
March 2018: Skin Therapy Letter
https://www.readbyqxmd.com/read/29357215/new-treatments-for-hereditary-angioedema
#5
Nathan M Johnson, Mariana A Phillips
Hereditary angioedema is characterized by severe, episodic edema of the subcutaneous and mucosal tissue. The disease carries significant morbidity and mortality due to involvement of the gastrointestinal tract and upper airway. Recent advances in the treatment of hereditary angioedema include new techniques used to isolate and purify human-derived C1 inhibitor, the production of a recombinant form of C1 inhibitor, and the development of drugs that target the kallikrein-kinin pathway. This paper reviews the mechanisms, efficacy, and adverse reactions associated with these medications...
January 2018: Skin Therapy Letter
https://www.readbyqxmd.com/read/29357214/skin-and-diet-an-update-on-the-role-of-dietary-change-as-a-treatment-strategy-for-skin-disease
#6
Rajani Katta, Mary Jo Kramer
An increasing body of research indicates that dietary change may serve as a component of therapy for certain skin conditions. This includes conditions such as acne, atopic dermatitis, aging skin, psoriasis, and rosacea. Certain nutrients, foods, or dietary patterns may act as disease "triggers", while others may prove beneficial. Avoidance or elimination diets may be helpful in some conditions, although testing may be recommended first. In terms of beneficial effects, an eating pattern that emphasizes the consumption of whole foods over highly processed foods may help in the treatment of certain skin conditions, and will certainly help in the prevention of associated co-morbidities...
January 2018: Skin Therapy Letter
https://www.readbyqxmd.com/read/29091380/real-world-efficacy-of-azelaic-acid-15-gel-for-the-reduction-of-inflammatory-lesions-of-rosacea
#7
P J Wirth, M H Henderson Berg, N Sadick
Approximately 16 million Americans have rosacea, an inflammatory cutaneous disorder with central facial erythema, papules, pustules, telangiectasia, flushing, and swelling being among the more commonly recognized features. Overexpression of cathelicidin peptide LL-37 has been implicated in the pathophysiology of rosacea. Azelaic acid has been found to inhibit the pathologic expression of cathelicidin, as well as the hyperactive protease activity that cleaves cathelicidin into LL-37. Given these findings, a small prospective, open-label, interventional trial was undertaken to assess the effects of azelaic acid 15% gel on inflammatory lesions of papulopustular rosacea in a real-world setting...
November 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/29091379/dupilumab-for-moderate-to-severe-atopic-dermatitis
#8
R Vangipuram, S K Tyring
Atopic dermatitis (AD) is the most common chronic inflammatory disease affecting 2-10% of adults and up to 15-30% of children. Despite a rising prevalence, effective and safe therapeutics for patients with moderate-to-severe AD are limited due to toxicity and side effects. Dupilumab, an interleukin (IL)-4 and IL-13 antagonist that limits type 2 T helper (Th2) driven inflammatory activity, is a promising therapeutic option. In clinical trials, it has demonstrated efficacy by reducing clinical activity and symptoms, and showed improvement in the AD genomic phenotype, including a significant reduction in Th2 chemokines and reversal of key epidermal markers of AD...
November 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28888217/epidermal-growth-factor-receptor-inhibitors-cutaneous-side-effects-and-their-management
#9
REVIEW
S Monjazeb, J Wilson
Epidermal growth factor receptor (EGFR) inhibitors are part of an emerging class of anticancer medicines known as "targeted therapy," which target pathways more specific to neoplastic proliferation than traditional chemotherapeutic agents. Adverse effects of such treatments are thought to be less severe, but can still be significant. Because EGFR is preferentially expressed in epithelial tissues, including the skin and hair follicle, cutaneous side effects of these agents are quite common. Not only can these toxicities severely affect patients' quality of life, but in some specific instances, they can be associated with increased response to therapy...
September 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28888216/vitamin-b-derivative-nicotinamide-appears-to-reduce-skin-cancer-risk
#10
REVIEW
S Nazarali, P Kuzel
Nicotinamide, an amide form of vitamin B3, has shown the potential to treat a variety of dermatological conditions, including acne, rosacea, and atopic dermatitis. Recent studies have demonstrated the role of nicotinamide, in both topical and oral forms, as a chemopreventive agent against skin cancer. Its anti-carcinogenic role may be due to its ability to enhance DNA repair and prevent ultraviolet (UV)-induced immunosuppression, which is known to contribute to the progression of pre-malignant lesions. Furthermore, nicotinamide is a precursor of essential coenzymes for many important reactions in the body, including the production of nicotinamide adenine dinucleotide (NAD)...
September 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28732153/hepatitis-b-and-c-viruses-and-biologics
#11
REVIEW
P Grewal, R Sanghera
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are common, worldwide viral illnesses that potentially impact the clinician's ability to manage patients with immunosuppressive medications such as biological therapy. In light of recent literature reviews, patients with HBV and HCV should be referred to a hepatologist or infectious disease expert prior to initiation of biological therapy.
July 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28732152/secukinumab-in-the-treatment-of-psoriasis-and-psoriatic-arthritis-a-review-of-the-literature
#12
REVIEW
M Abrouk, J Gandy, M Nakamura, K Lee, M Brodsky, R Singh, H Zhu, B Farahnik, T Bhutani, J Koo
While there are several commercially available treatment options for psoriasis and psoriatic arthritis, there remains a large number of individuals who are refractory to current modalities. In the recent past, there has been increasing evidence that interleukin (IL)-17 plays a vital role in the pathophysiology of psoriasis. Preclinical, phase II, and phase III studies of secukinumab (Cosentyx®) targeting IL-17 and its receptor have thus far proved to be promising. We reviewed the results of phase II and phase III clinical trials for secukinumab in the treatment of psoriasis and psoriatic arthritis...
July 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28492949/the-role-of-skin-care-in-optimizing-treatment-of-acne-and-rosacea
#13
REVIEW
C Zip
A triad approach to the treatment of acne and rosacea has been recommended. This integrated management approach includes patient education, selection of therapeutic agents, and initiation of an appropriate skin care regime. Proper skin care in patients undergoing treatment of both acne and rosacea includes use of products formulated for sensitive skin that cleanse, moisturize and photoprotect the skin. Both acne and rosacea are associated with epidermal barrier dysfunction, which can be mitigated by suitable skin care practices...
May 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28486717/psoriasis-depression-and-suicidality
#14
REVIEW
M N Nicholas, M Gooderham
Psoriasis is a chronic condition that affects the well-being and quality of life of patients. The disease is associated with an increased risk of depression and suicidality, which may not be fully understood by the general population. It is crucial to understand the effect this disease has on mental health and determine risk factors that may help identify patients who are susceptible to depression and suicidality. Risk factors discussed in this article include age, gender, and severity of disease in psoriasis patients...
May 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28329405/a-review-of-guselkumab-an-il-23-inhibitor-for-moderate-to-severe-plaque-psoriasis
#15
REVIEW
Z Nawas, M Hatch, E Ramos, M Liu, Y Tong, A Peranteau, S Tyring
Psoriasis is a chronic inflammatory skin disorder that affects 2% of the population. Evidence suggests that interleukin (IL)-23 plays a pivotal role in the pathogenesis of psoriasis. Guselkumab is a subcutaneously administered, humanized anti-IL23 monoclonal antibody indicated for the treatment of moderate-to-severe plaque psoriasis. Data from Phase I-III trials in this patient population reveal that guselkumab has proven to be superior to placebo or adalimumab based on achieving a Psoriasis Area and Severity Index (PASI) 90% reduction, or a static Physician Global Assessment (sPGA) score of 0 or 1 from baseline...
March 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28329404/tofacitinib-in-the-treatment-of-rheumatoid-arthritis-and-chronic-plaque-psoriasis
#16
REVIEW
A K Gupta, M Cernea, C W Lynde
Tofacitinib is an oral immunosuppressant approved for the treatment of rheumatoid arthritis (RA) and is currently undergoing investigation (Phase III trials) for treating chronic plaque psoriasis. Tofacitinib inhibits Janus kinases (JAKs), which are essential for the signaling of multiple inflammatory pathways and have been implicated in the pathogenesis of RA and psoriasis. The efficacy and safety of tofacitinib in the treatment of RA and psoriasis have been demonstrated in Phase III trials. Across all studies, the efficacy of tofacitinib in alleviating symptoms of RA and psoriasis were superior to placebo...
March 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28122093/a-dermatologist-s-guide-to-infection-screening-prior-to-initiating-immunosuppressive-therapy
#17
REVIEW
M G Ponzo, C H Hong
Dermatologists have within their armamentarium numerous immunosuppressant agents, both traditional and new, that are useful in the treatment of chronic cutaneous disorders such as autoimmune bullous diseases and psoriasis. It is imperative that users of these agents are aware of potential sequelae from therapy, particularly infections. In this review, we summarize the most common immunosuppressant medications currently used in dermatology, and provide recommendations for infection screening prior to initiating treatment...
January 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/28122092/a-review-of-brodalumab-an-il-17-receptor-antagonist-for-moderate-to-severe-plaque-psoriasis
#18
REVIEW
Y Tong, A J Peranteau, Z Nawas, S K Tyring
Psoriasis is a chronic immune-mediated inflammatory disease with epidermal hyperplasia that affects 2-3% of the population. Interleukin (IL)-17 signaling has a central role in its pathogenesis. Brodalumab is a monoclonal antibody that neutralizes IL-17 receptor type A. Brodalumab is highly effective in the reversal of psoriatic phenotype and gene expression patterns.
January 2017: Skin Therapy Letter
https://www.readbyqxmd.com/read/27825175/update-on-efinaconazole-10-topical-solution-for-the-treatment-of-onychomycosis
#19
A K Gupta, C Studholme
Efinaconazole 10% nail solution is a novel topical antifungal drug for the treatment of onychomycosis. Two Phase III trials were completed using efinaconazole 10% nail solution, where 17.8% and 15.2% of patients achieved complete cure, and 55.2% and 53.4% achieved mycological cure. Several post hoc analyses were carried out using data from Phase III trials to determine the efficacy of efinaconazole with respect to disease duration, disease progression, and comorbidities of diabetes or tinea pedis with onychomycosis...
November 2016: Skin Therapy Letter
https://www.readbyqxmd.com/read/27825174/a-review-of-ixekizumab-an-anti-interleukin-17a-monoclonal-antibody-for-moderate-to-severe-plaque-psoriasis
#20
REVIEW
A J Peranteau, A E Turkeltaub, Y Tong, Z Nawas, S K Tyring
Psoriasis is a multifactorial chronic skin disease that can have significant detrimental effects on patients' physical, mental, antibodypsychosocial wellbeing. Patients often suffer from a decreased quality of life along with numerous comorbidities. Recent advances in our understanding of the innate and adaptive immune systems have led to the identification of interleukin (IL)-17 as a key pro-inflammatory mediator in psoriasis. This knowledge has in turn led to the development of newer biologic agents that have been shown to be more effective than traditional therapies...
November 2016: Skin Therapy Letter
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