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American Journal of Clinical Dermatology

Noa Kremer, Igor Snast, Efrat Solomon Cohen, Emmilia Hodak, Daniel Mimouni, Moshe Lapidoth, Sigal Mazor, Assi Levi
BACKGROUND: Bullous pemphigoid (BP) is the most common autoimmune blistering skin disease worldwide. Systemic corticosteroids are considered the mainstay of therapy; however, they may cause significant adverse effects and treatment failures, so additional therapeutic modalities with better safety profiles are required. Rituximab and omalizumab are novel biologic agents administered in recent years for the treatment of BP, yet data regarding their use in the disease are limited. OBJECTIVE: Our objective was to systematically review the current literature regarding the use of rituximab and omalizumab for the treatment of BP to evaluate their safety and efficacy...
November 13, 2018: American Journal of Clinical Dermatology
April W Armstrong, Kristian Reich, Peter Foley, Chenglong Han, Michael Song, Yaung-Kaung Shen, Yin You, Kim A Papp
BACKGROUND: Health-related quality of life (HRQoL) may be markedly impaired in patients with moderate-to-severe psoriasis. OBJECTIVES: Our objectives were to compare improvements in Dermatology Life Quality Index (DLQI) and Psoriasis Symptoms and Signs Diary (PSSD) scores between patients receiving guselkumab compared with placebo or adalimumab and to correlate these improvements with skin clearance. METHODS: Pooled phase III VOYAGE 1 and VOYAGE 2 data were evaluated through week 24...
November 12, 2018: American Journal of Clinical Dermatology
Dustin H Marks, Lauren R Penzi, Erin Ibler, Athena Manatis-Lornell, Dina Hagigeorges, Mariko Yasuda, Lynn A Drake, Maryanne M Senna
Alopecia encompasses a broad range of hair loss disorders, generally categorized into scarring and non-scarring forms. Depending on the specific pathogenesis of hair loss and geographic location, a number of psychiatric and medical comorbidities, including but not limited to thyroid disease, lupus erythematosus, diabetes mellitus, atopic dermatitis, sinusitis, coronary artery disease, anxiety, depression, and suicidality, have been identified in association with alopecia. In addition to the numerous associated comorbid conditions, patients with alopecia report decreased quality-of-life measures across symptomatic, functional, and global domains...
November 2, 2018: American Journal of Clinical Dermatology
David M Pariser, Adelaide A Hebert, Janice Drew, John Quiring, Ramanan Gopalan, Dee Anna Glaser
BACKGROUND: Glycopyrronium tosylate (GT) is a topical anticholinergic approved in the USA for primary axillary hyperhidrosis in patients aged ≥ 9 years. GT was evaluated for primary axillary hyperhidrosis in replicate, randomized, double-blind, vehicle-controlled, phase III trials. GT reduced sweating severity and production versus vehicle and was generally well tolerated. OBJECTIVE: Our objective was to evaluate patient-reported outcomes (PROs) from these trials...
October 30, 2018: American Journal of Clinical Dermatology
Mario Lacouture, Vincent Sibaud
Targeted therapies and immunotherapies are associated with a wide range of dermatologic adverse events (dAEs) resulting from common signaling pathways involved in malignant behavior and normal homeostatic functions of the epidermis and dermis. Dermatologic toxicities include damage to the skin, oral mucosa, hair, and nails. Acneiform rash is the most common dAE, observed in 25-85% of patients treated by epidermal growth factor receptor and mitogen-activated protein kinase kinase inhibitors. BRAF inhibitors mostly induce secondary skin tumors, squamous cell carcinoma and keratoacanthomas, changes in pre-existing pigmented lesions, as well as hand-foot skin reactions and maculopapular hypersensitivity-like rash...
October 30, 2018: American Journal of Clinical Dermatology
Fernando Stengel
The solar radiation range has harmful and beneficial effects. Sunscreens, which selectively block specific spectral regions, may potentially interfere with skin homeostasis. For instance, the ultraviolet (UV) B waveband produces erythema and DNA damage; simultaneously, it induces pre-vitamin D3 synthesis. UVA1 and visible light can both induce pigmentation in skin phototypes IV-VI, and act in synergy to induce erythema and persistent pigment darkening. In contrast, UVA may contribute to blood pressure control and cardioprotection by inducing release of nitric oxide from intracutaneous photolabile nitric oxide derivatives...
October 30, 2018: American Journal of Clinical Dermatology
Renato Marchiori Bakos, Tatiana Pinto Blumetti, Rodrigo Roldán-Marín, Gabriel Salerni
In the 1980s, the increasing incidence of skin cancers prompted the development of noninvasive medical devices to improve skin cancer diagnosis in daily dermatology practice. As a result of the development of these noninvasive techniques, diagnosis is now established earlier and with better accuracy. These advances are of great benefit to high-risk patients, who previously would have had to undergo several excisions. In this review, we focus on the classic technique of dermoscopy and the more recent digital version, as well as on advanced noninvasive imaging techniques, such as reflectance confocal microscopy and optical coherence tomography...
October 30, 2018: American Journal of Clinical Dermatology
Raúl Cabrera, Francisca Recule
This review presents the main challenges encountered when diagnosing unusual variants of malignant melanoma with the aim of raising awareness to allow application of the most appropriate treatment strategies. Although these melanomas are often rare, their misdiagnosis potentially jeopardizes patients' health and survival, and has medicolegal implications. The clinical and histologic presentations of melanoma vary greatly, and assessment of uncommon melanomas can be difficult for practitioners because of their scarcity and resemblance to other dermatologic entities...
October 30, 2018: American Journal of Clinical Dermatology
Abel Gonzalez
Although significant progress has been made in the understanding of melanoma pathophysiology and therapy, patients with metastatic melanoma still have a poor prognosis. The management of regional nodes remains a matter of debate. By replacing elective lymph node dissection, sentinel lymph node biopsy has revolutionized the treatment of malignant melanoma. In this paper, the history of the procedure is traced, and the indication for completion lymphadenectomy after positive sentinel node biopsy is discussed in light of the recent studies that addressed this issue...
October 30, 2018: American Journal of Clinical Dermatology
Fernando Stengel
No abstract text is available yet for this article.
October 30, 2018: American Journal of Clinical Dermatology
Amanda F Nahhas, Taylor L Braunberger, Iltefat H Hamzavi
Drug-induced pigmentation accounts for up to 20% of all cases of acquired pigmentation. A thorough review of medical history and previous and ongoing medications as well as a complete skin examination can guide diagnosis. Implicated agents include alkylating/cytotoxic agents, analgesics, antiarrhythmics, anticoagulants, antiepileptics, antimalarials, antimicrobials, antiretrovirals, metals, prostaglandin analogs, and psychotropic agents, among others. Confirming true drug associations can be challenging, especially in the setting of delayed onset of pigmentation and coexisting polypharmacy...
October 29, 2018: American Journal of Clinical Dermatology
Russell J Diefenbach, Jenny H Lee, Helen Rizos
Genetic material derived from tumours is constantly shed into the circulation of cancer patients both in the form of circulating free nucleic acids and within circulating cells or extracellular vesicles. Monitoring cancer-specific genomic alterations, particularly mutant allele frequencies, in circulating nucleic acids allows for a non-invasive liquid biopsy for detecting residual disease and response to therapy. The advent of molecular targeted treatments and immunotherapies with increasing effectiveness requires corresponding effective molecular biology methods for the detection of biomarkers such as circulating nucleic acid to monitor and ultimately personalise therapy...
October 29, 2018: American Journal of Clinical Dermatology
Chia-Yu Liu, Tao-Hsin Tung, Chin-Yu Lee, Kuo-Hsuan Chang, Shu-Hui Wang, Ching-Chi Chi
BACKGROUND: Previous studies have reported the occurrence of psoriasis together with multiple sclerosis (MS). Although similar predisposing genes and pathomechanisms have been hypothesized, the relationship between the two remains obscure. OBJECTIVE: The aim of this systematic review and meta-analysis was to investigate the association between psoriasis and MS. METHODS: We searched MEDLINE, Embase, and CENTRAL in July 2018 for case-control, cross-sectional, or cohort studies that examined either the odds or risk of psoriasis in subjects with multiple sclerosis...
October 25, 2018: American Journal of Clinical Dermatology
Patrick M Jedlowski, Charisse H Te, Robert J Segal, Maryam T Fazel
Diabetes mellitus is one of the most prevalent chronic diseases in the USA. If uncontrolled, diabetes can lead to devastating complications. Diabetes medications and medical devices largely contribute to the significant financial expense that the disease inflicts on affected individuals and society. Alongside significant economic burden, there are numerous cutaneous adverse effects associated with diabetes medications and medical devices. Despite the large and increasing number of individuals living with diabetes and the wide use of the related medications and medical devices, there is limited literature that comprehensively documents their cutaneous adverse effects...
October 25, 2018: American Journal of Clinical Dermatology
Marie Hamilton Larsen, Kåre Birger Hagen, Anne Lene Krogstad, Astrid Klopstad Wahl
BACKGROUND: Patients with psoriasis face numerous treatment and self-management decisions. Shared decision making is a novel approach where patients' preferences and values are considered in cooperation with healthcare professionals before making treatment decisions. OBJECTIVE: The objective of this systematic review was to explore what is illuminated in psoriasis research regarding shared decision making, and to estimate the effects of shared decision-making interventions in this context...
October 15, 2018: American Journal of Clinical Dermatology
Hsi Yen, Ching-Chi Chi
BACKGROUND: The relationship between psoriasis and vitiligo has not been previously confirmed, and we therefore aimed to investigate this association. METHODS: We conducted a search of the MEDLINE and EMBASE electronic databases on 22 January 2018 for case-control, cross-sectional, and cohort studies examining the association between psoriasis and vitiligo. A customized Newcastle-Ottawa Scale was used to assess the risk of bias of the included studies. We performed a random effects meta-analysis to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs) for case-control and cross-sectional studies...
October 13, 2018: American Journal of Clinical Dermatology
Cynthia X Wang, Milan J Anadkat, Amy C Musiek
Hematopoietic stem cell transplants (HSCTs) are used to treat a variety of conditions, including hematologic malignancies, bone marrow failure syndromes, and immunodeficiencies. Over 60,000 HSCTs are performed annually worldwide, and the numbers continue to increase. Indeed, as new conditioning regimens develop, more and more individuals, including those of older age, will be eligible for transplants. Nevertheless, although HSCTs are clearly a life-saving and necessary treatment for thousands of patients per year, there is still substantial morbidity and mortality associated with the procedure...
October 8, 2018: American Journal of Clinical Dermatology
Sanminder Singh, Robert E Kalb, Elke M G J de Jong, Neil H Shear, Mark Lebwohl, Wayne Langholff, Lori Hopkins, Bhaskar Srivastava, April W Armstrong
OBJECTIVE: Our objective was to compare therapeutic response among patients with early-onset psoriasis (EOP) and late-onset psoriasis (LOP) receiving adalimumab, etanercept, infliximab, ustekinumab, or methotrexate in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). METHODS: Patients were grouped by age of onset: EOP (age ≤ 40 years) or LOP (age > 40 years). Repeated-measures analysis with logistic regression was used to calculate the adjusted odds ratio (AOR; adjusted for baseline characteristics) for achieving a Physician's Global Assessment score of cleared/minimal (PGA 0/1) or a percentage of body surface area involved with psoriasis < 3% (%BSA < 3) or %BSA < 1 for all patients; similar sensitivity analyses were performed for each treatment group...
September 28, 2018: American Journal of Clinical Dermatology
David Liu, Russell W Jenkins, Ryan J Sullivan
The recent development of effective immune checkpoint inhibition (ICI), first demonstrated in melanoma, has revolutionized cancer treatment. Monoclonal antibodies blocking the immune checkpoints cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and programmed death 1 receptor (PD-1) have shown substantial clinical benefit in a subset of patients across tumor types and in both the metastatic and adjuvant settings. In this article, we review the interaction between the immune system and solid tumors, and describe modes of immune response failure and the physiologic role of immune checkpoints...
September 26, 2018: American Journal of Clinical Dermatology
Poonkiat Suchonwanit, Wimolsiri Iamsumang, Salinee Rojhirunsakool
BACKGROUND: The relationship between female pattern hair loss (FPHL) and androgenic hormones is not well established, but some evidence indicates oral finasteride may be efficacious in FPHL. Use of a topical formulation has been proposed to minimize unwanted effects. OBJECTIVES: Our objective was to compare the efficacy and safety of topical 0.25% finasteride combined with 3% minoxidil solution and 3% minoxidil solution as monotherapy in the treatment of FPHL. METHODS: This was a prospective, randomized, double-blind study in 30 postmenopausal women with FPHL...
September 11, 2018: American Journal of Clinical Dermatology
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