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American Journal of Clinical Dermatology

James E Frampton, Hannah A Blair
Dupilumab (Dupixent® ), a subcutaneously administered, fully human IgG4 monoclonal antibody directed against the IL (interleukin)-4 receptor α subunit, blocks the signalling of IL-4 and IL-13, two T helper cell type 2 cytokines implicated in the immunopathology of atopic dermatitis (AD). It is the first biologic therapy to have been approved for the treatment of adult patients with moderate-to-severe AD in the EU and USA. In phase III trials in adults with moderate-to-severe AD who were inadequately controlled with topical medications and/or systemic treatments, such as ciclosporin, or for whom these therapies were not advisable, 16 weeks' treatment with dupilumab as monotherapy or in combination with topical corticosteroids (TCS) improved multiple measures of disease severity, pruritus, sleep disturbance, anxiety and depression, and quality of life compared with placebo...
July 20, 2018: American Journal of Clinical Dermatology
Sofie Mylle, Lynda Grine, Reinhart Speeckaert, Jo L W Lambert, Nanja van Geel
New promising treatments have been developed for psoriasis that target different parts of the interleukin (IL)-23/IL-17 pathway. This approach is believed to be more disease specific, and sparing the T helper 1 pathway might prevent serious long-term adverse events. Moreover, superior Psoriasis Area and Severity Index improvements are observed, which has redefined treatment goals in psoriasis. The new molecules can be divided into different categories, according to the target: blocking agents can target the upstream cytokine IL-23 or the downstream IL-17...
July 12, 2018: American Journal of Clinical Dermatology
Andrew Lee, Gayle Fischer
Vulvar lichen sclerosus is an important skin disease that is common in women in their 50 s and beyond; however, it can also affect females of any age, including children. If not treated, it has the potential to cause significant and permanent scarring and deformity of the vulvar structure. In addition, if untreated, it is associated with a 2-6% lifetime risk of malignant squamous neoplasia of the vulva. Lichen sclerosus has been considered a difficult to manage condition; however, both serious complications can potentially be prevented with early intervention with topical corticosteroid, suggesting that the course of the disease can be treatment modified...
July 9, 2018: American Journal of Clinical Dermatology
Ludimila Cavalcante, Akansha Chowdhary, Jeffrey A Sosman, Sunandana Chandra
The field of tumor immunology has faced many complex challenges over the last century, but the approval of immune checkpoint inhibitors (anti-cytotoxic T-lymphocyte-associated protein 4 [CTLA4] and anti-programmed cell death-1 [PD-1]/PD-ligand 1 [PD-L1]) and talimogene laherparepvec (T-VEC) for the treatment of metastatic melanoma have awakened a new wave of interest in cancer immunotherapy. Additionally, combinations of vaccines and oncolytic viral therapies with immune checkpoint inhibitors and other systemic agents seem to be promising synergistic strategies to further boost the immune response against cancer...
June 30, 2018: American Journal of Clinical Dermatology
Amanda F Nahhas, David M Oberlin, Taylor L Braunberger, Henry W Lim
Photodermatoses occur in males and females of all races and ages. Onset can be variable in timing and influenced by genetic and environmental factors. Photodermatoses are broadly classified as immunologically mediated, chemical- and drug-induced, photoaggravated, and genetic (defective DNA repair or chromosomal instability) diseases. Advances in the field have led to improved recognition and treatment of many photodermatoses. The purpose of this focused review is to provide an update on the diagnosis and management of a variety of photodermatoses, both common and less common, with review of recent updates in the literature pertaining to their diagnosis and management...
June 29, 2018: American Journal of Clinical Dermatology
Siriorn Udompanich, Kumutnart Chanprapaph, Poonkiat Suchonwanit
Cutaneous and systemic lupus erythematosus (SLE) commonly involves the hair and scalp. Alopecia can result from direct activity of disease on the scalp or from the state of physical stress in the form of telogen effluvium. Discoid lupus erythematosus and lupus panniculitis/profundus are known to cause scarring alopecia, while accumulation of recent studies has shown that non-scarring alopecia in SLE may have different subtypes, comprising lupus erythematosus-specific and lupus erythematosus-nonspecific changes on histology...
June 9, 2018: American Journal of Clinical Dermatology
Nicola E Natsis, Philip R Cohen
Coagulase-negative staphylococcus organisms may be normal flora of human skin, however these bacteria can also be pathogens in skin and soft tissue infections. A summary of skin and soft tissue infections caused by coagulase-negative staphylococcus species is provided in this review. We conducted a search of the PubMed database using the following terms: abscess, auricularis, biofilm, capitis, cellulitis, coagulase, contaminant, cyst, draining, epidermidis, felon, folliculitis, furuncle, haemolyticus, hominis, indolent, infection, lugdunensis, mecA, microbiome, negative, osteomyelitis, paronychia, saprophyticus, skin, simulans, sinus, soft, staphylococcus, systemic, tissue, virulence, virulent, and vulvar...
June 7, 2018: American Journal of Clinical Dermatology
José Alberto García-Lozano, Jorge Ocampo-Candiani, Sylvia Aide Martínez-Cabriales, Verónica Garza-Rodríguez
Calciphylaxis, also known as calcific uremic arteriolopathy and uremic small artery disease with medial wall calcification and intimal hyperplasia, is a multifactorial cutaneous vascular disease characterized by chronic, painful, non-healing wounds that occur frequently in patients with chronic kidney disease, predominantly in those with end-stage renal disease. The pathogenesis remains unclear, and the development of calciphylaxis lesions depends on medial calcification, intimal fibrosis of arterioles and thrombotic occlusion...
May 28, 2018: American Journal of Clinical Dermatology
Colin A Morton, Lasse R Braathen
Topical photodynamic therapy (PDT) using daylight is effective in the treatment of actinic keratoses (AKs), offering the potential for treatment of large fields such as full face and balding scalp, but with minimal therapy-associated pain. Comparison with conventional PDT indicates similar efficacy for thin and moderate-thickness AKs, but with significantly less discomfort/pain, driving a patient preference for daylight-mediated PDT (DL-PDT) compared with conventional PDT using high-intensity office/hospital-based light sources...
May 11, 2018: American Journal of Clinical Dermatology
Shashank Bhargava, Paulo R Cunha, Jennifer Lee, George Kroumpouzos
BACKGROUND: Modalities for atrophic acne scarring can be classified depending upon the needs they satisfy; that is, resurfacing, lifting/volumization, tightening, or surgical removal/movement of tissue that is required for correction. A plethora of treatment options have resulted from the need to treat various acne scar types, variability of responses noted in various skin types, and increasing popularity of minimally invasive modalities. Still, there is a lack of consensus guidelines on treatment or combination therapies for various clinical scenarios...
May 9, 2018: American Journal of Clinical Dermatology
Khalaf Kridin, Arnon D Cohen, Kyle T Amber
BACKGROUND: There is little consensus regarding the prevalence and distribution of underlying systemic diseases among patients with pyoderma gangrenosum. OBJECTIVE: The objective of this study was to synthesize existing data on the prevalence of associated systemic diseases in patients with pyoderma gangrenosum. METHODS: We performed a systematic review and meta-analysis of observational studies in MEDLINE, EMBASE, and Scopus (1823-2017). The quality of evidence was assessed using a modified Newcastle-Ottawa Scale...
May 2, 2018: American Journal of Clinical Dermatology
Eric J Yang, Kristen M Beck, Wilson Liao
No abstract text is available yet for this article.
June 2018: American Journal of Clinical Dermatology
Andrew Blauvelt, Kim A Papp, Christopher E M Griffiths, Luis Puig, Jamie Weisman, Yves Dutronc, Lisa Farmer Kerr, Dapo Ilo, Lotus Mallbris, Matthias Augustin
The article Efficacy and Safety of Switching to Ixekizumab in Etanercept Non-Responders: A Subanalysis from Two Phase III Randomized Clinical Trials in Moderate-to-Severe Plaque Psoriasis (UNCOVER-2 and -3) written by Andrew Blauvelt.
June 2018: American Journal of Clinical Dermatology
Joyce H Park, Amanda Bienenfeld, Seth J Orlow, Arielle R Nagler
BACKGROUND: Little is known about how dermatologists prescribe hormonal antiandrogen acne treatment (HAAT). OBJECTIVE: The aim of this study was to investigate dermatologists' HAAT-prescribing habits and HAAT's impact on systemic antibiotic use in women with acne. METHODS: We performed a retrospective study at an academic medical center of female patients receiving HAAT (combined oral contraceptive [COC], spironolactone) for acne from January 2005 to October 2015...
June 2018: American Journal of Clinical Dermatology
Bridget P Kaufman, Andrew F Alexis
In the original publication, section 5, paragraph 1 was incorrectly published.
June 2018: American Journal of Clinical Dermatology
Ulrich Mrowietz, Tal Hetzroni Kedem, Rita Keynan, Meir Eini, Dov Tamarkin, Dror Rom, Mitchell Shirvan
OBJECTIVE: Our objective was to demonstrate the safety, tolerability, and efficacy of a minocycline foam, FMX103, in the treatment of moderate-to-severe facial papulopustular rosacea. METHODS: This was a phase II, randomized, double-blind, multicenter study. Healthy subjects aged ≥ 18 years with moderate-to-severe rosacea that had been diagnosed ≥ 6 months previously and with ≥ 12 inflammatory facial lesions were randomized (1:1:1) to receive once-daily 1...
June 2018: American Journal of Clinical Dermatology
Carolyn J Kushner, Josef Symon S Concha, Victoria P Werth
Autoimmune bullous diseases (AIBD), including pemphigus, bullous pemphigoid, epidermolysis bullosa acquisita, mucous membrane pemphigoid, and pemphigoid gestationis, pose significant therapeutic challenges, especially in pregnant and post-partum breastfeeding patients or those planning to conceive. Data on the safety and efficacy of therapeutic interventions during the perinatal period are lacking because randomized controlled trials are typically not performed in this setting. However, many of the treatments for AIBD are also used in other diseases, so data can be extrapolated from studies or case reports in these other patient populations...
June 2018: American Journal of Clinical Dermatology
Caitriona Ryan, Jeffrey M Sobell, Craig L Leonardi, Charles W Lynde, Mahinda Karunaratne, Wendell C Valdecantos, Barbara A Hendrickson
BACKGROUND: Adalimumab is approved for the treatment of hidradenitis suppurativa (HS), plaque psoriasis, and other inflammatory conditions. OBJECTIVE: Our objective was to examine the safety of adalimumab administered every other week (EOW) and every week (EW) in patients with HS and psoriasis and to investigate informative data from non-dermatologic indications. METHODS: The safety of adalimumab 40-mg EOW versus EW dosing was examined during placebo-controlled and open-label study periods in patients with HS (three studies), psoriasis (two studies), Crohn's disease (six studies), ulcerative colitis (three studies), and rheumatoid arthritis (one study)...
June 2018: American Journal of Clinical Dermatology
Joshua L Owen, Paras P Vakharia, Jonathan I Silverberg
Patients with atopic dermatitis (AD) have increased penetration of allergens, immune dysregulation (including shared cytokine pathways), and frequent use of emollients and topical medications, all of which may predispose toward developing allergic contact dermatitis (ACD). Recent systematic reviews have suggested that ACD is a significant clinical problem in both children and adults with AD. While this remains controversial, ACD remains an important comorbidity and potential exacerbant of AD in clinical practice...
June 2018: American Journal of Clinical Dermatology
Dingyuan Wang, Vanessa Cui-Lian Chong, Wei-Sheng Chong, Hazel H Oon
Pityriasis rubra pilaris (PRP) is an idiopathic, papulosquamous inflammatory dermatosis. It is characterized by hyperkeratotic follicular papules coalescing into orange-red scaly plaques, islands of sparing, and palmoplantar keratoderma. PRP can be subdivided into six clinical subtypes according to Griffiths' classification, based on age of onset, disease extent, prognosis, and other associated features. The sixth subtype of PRP occurs in individuals affected by HIV infection, and retroviral screening in all de novo cases of PRP is advised...
June 2018: American Journal of Clinical Dermatology
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