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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
Adriana T Lopez, Susan Bates, Larisa Geskin
Cutaneous T-cell lymphomas (CTCLs) are a heterogeneous group of lymphomas that are characterized by primary skin involvement. Mycosis fungoides (MF) and Sézary syndrome (SS), the two most common subtypes of CTCL, can be difficult to manage clinically as there are few effective treatment options available. Recently, histone deacetylase inhibitors (HDACi) have emerged as promising therapies with favorable adverse effect profiles, compared with traditional chemotherapies. In this article, we review the published literature to evaluate the role of HDACi in the treatment of CTCL...
September 1, 2018: American Journal of Clinical Dermatology
James P Winebrake, Kartikey Grover, Pierre Halteh, Shari R Lipner
BACKGROUND: Onychophagia, defined as habitual nail biting, is a common disorder affecting 6-45% of the population and is more prevalent in children. OBJECTIVES: Our primary objective was to determine the prevalence of nail biting in the pediatric population. Secondary objectives were to assess the presence of psychiatric co-morbidities associated with nail biting, and the effect of treatment on nail biting. METHODS: An anonymous voluntary survey was administered to participants at an outpatient academic pediatric clinic at Weill Cornell Medicine...
August 31, 2018: American Journal of Clinical Dermatology
Amy Paller, Jennifer C Jaworski, Eric L Simpson, Mark Boguniewicz, John J Russell, Julie K Block, Susan Tofte, Jeffrey D Dunn, Steven R Feldman, Adele R Clark, Gene Schwartz, Lawrence F Eichenfield
The consequences of atopic dermatitis reach beyond the skin and past childhood. Patients with atopic dermatitis are at risk of developing allergic comorbidities, but less is known about the associations between atopic dermatitis and non-allergic conditions. Understanding these non-allergic comorbidities has the potential to improve patient outcomes and to help mitigate the cost and burdens associated with these conditions. Atopic dermatitis is associated with cutaneous bacterial infections, more severe forms/courses of cutaneous viral infections, and extra-cutaneous infections...
August 30, 2018: American Journal of Clinical Dermatology
Jina Chung, Dilek Ince, Bradley A Ford, Karolyn A Wanat
Nontuberculous mycobacteria (NTM) are a diverse group of organisms that are ubiquitous in the environment, and the incidence of cutaneous infections due to NTM has been steadily increasing. Cutaneous infections due to NTM can be difficult to diagnose, due to their wide spectrum of clinical presentations and histopathological findings that are often nonspecific. A variety of modalities including tissue culture and polymerase chain reaction (PCR) assays may be necessary to identify the organism. Treatment can also be challenging, as it can depend on multiple factors, including the causative organism, the patient's immunological status, and the extent of disease involvement...
August 30, 2018: American Journal of Clinical Dermatology
Lara El Hayderi, Nazli Nikkels-Tassoudji, Arjen F Nikkels
BACKGROUND: About 20% of children have cutaneous scars following chickenpox. In contrast, skin scars are not often reported after herpes zoster (HZ). Risk factors for post-HZ scarring remain undetermined. OBJECTIVE: Our objective was to prospectively study the incidence of and risk factors for post-HZ scarring. METHODS: This was a 3-year prospective study of patients with HZ attending a tertiary university hospital. Baseline data, including age, sex, immunosuppression, prior history of scarring, severity and extension of HZ, afflicted HZ dermatome, and antiviral treatment received, were recorded...
August 27, 2018: American Journal of Clinical Dermatology
Jerry Bagel, Sergio Schwartzman
Psoriatic arthritis (PsA) is an inflammatory arthritis that is estimated to affect approximately 30% of patients with psoriasis. Enthesitis and dactylitis, two hallmarks of PsA, are associated with radiographic peripheral/axial joint damage and severe disease. Clinical symptoms of enthesitis include tenderness, soreness, and pain at entheses on palpation, whereas dactylitis is recognized by swelling of an entire digit that is different from adjacent digits. Both ultrasound and magnetic resonance imaging can be used to diagnose enthesitis and dactylitis, especially in patients in whom symptoms may be difficult to discern...
August 16, 2018: American Journal of Clinical Dermatology
Paras P Vakharia, Rishi Chopra, Nanette B Silverberg, Jonathan I Silverberg
BACKGROUND AND OBJECTIVE: Topical cantharidin is routinely used for the treatment of molluscum contagiosum and warts. The objective of this systematic review is to assess the efficacy and safety of topical cantharidin treatment for molluscum contagiosum and warts. METHODS: We performed a systematic review of studies assessing topical cantharidin treatment of molluscum contagiosum or warts. We searched the databases of Cochrane, EMBASE, GREAT, LILACS, MEDLINE, and Scopus...
August 10, 2018: American Journal of Clinical Dermatology
Poonkiat Suchonwanit, Amy J McMichael
The interaction between hair and malignancy is complicated. Various hair abnormalities can manifest in oncology patients as a clinical manifestation, the result of cancer therapy, or due to a paraneoplastic condition. The mechanisms of these changes remain unclear. Alopecia is one of the common clinical presentations occurring in oncology patients that affects their quality of life. The condition can concomitantly develop during the course of malignancy or when patients undergo cancer treatment. It is important for physicians to understand alopecia in association with malignancy as it may be an important associated finding or provide the clues to aid diagnosis...
August 7, 2018: American Journal of Clinical Dermatology
Macartney Welborn, Shelby L Kubicki, Naveen Garg, Anisha B Patel
BACKGROUND AND OBJECTIVES: Tremelimumab is a monoclonal human antibody that inhibits cytotoxic T-lymphocyte-associated antigen 4, giving rise to increased T cell activation and interleukin-2 release. While this activation of the immune system provides a mechanism to recognize and destroy cancer cells, it also leads to off-target immune-related adverse events. Ipilimumab is a US Food and Drug Administration-approved anti-cytotoxic T-lymphocyte-associated antigen 4 antibody, which has a high incidence of cutaneous adverse events...
August 2, 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
Jonathan I Silverberg, Robert W Kantor, Prarthana Dalal, Catherine Hickey, Sara Shaunfield, Karen Kaiser, Jin-Shei Lai, David Cella
BACKGROUND: Itch is common and often debilitating. Itch is best assessed by self-report, often using patient-reported outcome measures (PROMs). Current PROMs for itch are limited and may not capture its full impact on quality of life (QOL). OBJECTIVE: We sought to develop a comprehensive conceptual model of itch to improve the understanding of itch for clinicians and to serve as a framework for development of efficient and valid PROMs of itch. METHODS: Using mixed methods, including systematic review (n = 491 articles), semi-structured interviews (n = 33 adults with chronic itch with multiple etiologies), and grounded theory using a constant comparative approach, we developed a conceptual model of itch...
October 2018: American Journal of Clinical Dermatology
Andrew J Marek, Emily Y Chu, Michael E Ming, Zeeshan A Khan, Carrie L Kovarik
OBJECTIVE: The aim of this study was to evaluate the use of a mobile application (app) in patients already using total body photography (TBP) to increase skin self-examination (SSE) rates and pilot the effectiveness of examination reminders and accountability partners. DESIGN: Randomized controlled trial with computer generated randomization table to allocate interventions. SETTING: University of Pennsylvania pigmented lesion clinic. PARTICIPANTS: 69 patients aged 18 years or older with an iPhone/iPad, who were already in possession of TBP photographs...
October 2018: American Journal of Clinical Dermatology
Inés Poveda, Eva Vilarrasa, Antonio Martorell, Francisco Javier García-Martínez, Juan Manuel Segura, Patricia Hispán, José Sánchez-Payá, Pedro José Álvarez, Iris González, José Carlos Pascual
BACKGROUND: Serum zinc levels in patients with hidradenitis suppurativa (HS) have not been previously studied. OBJECTIVE: The aim was to investigate the association between HS and serum zinc levels. METHODS: A multicenter, prospective clinical and analytical case-control study was designed to assess the possible association between HS and serum zinc levels. Consecutive patients with moderate or severe HS (Hurley II or III exclusively) were enrolled...
October 2018: American Journal of Clinical Dermatology
Jason F Wang, Seth J Orlow
Keratosis pilaris is a common skin disorder comprising less common variants and rare subtypes, including keratosis pilaris rubra, erythromelanosis follicularis faciei et colli, and the spectrum of keratosis pilaris atrophicans. Data, and critical analysis of existing data, are lacking, so the etiologies, pathogeneses, disease associations, and treatments of these clinical entities are poorly understood. The present article aims to fill this knowledge gap by reviewing literature in the PubMed, EMBASE, and CINAHL databases and providing a comprehensive, analytical summary of the clinical characteristics and pathophysiology of keratosis pilaris and its subtypes through the lens of disease associations, genetics, and pharmacologic etiologies...
October 2018: American Journal of Clinical Dermatology
Meredith A McKean, Rodabe N Amaria
Locally advanced and metastatic melanoma have historically had poor survival outcomes. Long-term follow-up of both targeted therapies and immune checkpoint inhibitors has confirmed the survival benefit of these agents in stage IV melanoma, and recent studies have now demonstrated relapse-free survival benefits from these targeted and immunotherapeutic agents in the adjuvant setting. Neoadjuvant treatment of locally advanced melanoma, including in-transit disease, is now under investigation. Clinical trials have shown early promising results using either combination targeted therapy or immune checkpoint inhibitors...
October 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...
October 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...
October 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...
October 2018: American Journal of Clinical Dermatology
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