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Dermatology and Therapy

Philip R Cohen, Caesar A Anderson
Hyperkeratosis presents as thickened skin. It can be congenital or acquired. Typically, it affects the palms and soles; the distribution of epidermal involvement is either diffuse, focal, or punctate. Microscopically, the pathologic signature of hyperkeratosis is marked orthokeratosis of the stratum corneum. Topical treatments provide the mainstay of therapy for hyperkeratosis. These include keratolytics (such as urea, salicylic acid, and lactic acid) and retinoids; physical debridement, topical corticosteroids, and phototherapy (using topical psoralen and ultraviolet A phototherapy) are other local therapeutic modalities...
September 10, 2018: Dermatology and Therapy
Gabriella Fabbrocini, Maddalena Napolitano, Matteo Megna, Nicola Balato, Cataldo Patruno
Atopic dermatitis (AD) is a chronic, pruritic, inflammatory skin disease which predominately affects children and usually clears up during infancy or childhood. However, AD may persist with a chronic relapsing course until adulthood or develop at a later age. AD treatment can often be complicated. Treating moderate-to-severe AD can be challenging: only a few therapeutic options are available, with cyclosporine being the only approved and labeled systemic drug. In the last few years, advances in the knowledge of AD pathogenesis have been made that can provide the basis for developing new topical and systemic drugs...
September 4, 2018: Dermatology and Therapy
Kristen M Beck, Eric J Yang, Isabelle M Sanchez, Wilson Liao
Genital psoriasis affects approximately 63% of psoriasis patients at least once in their lifetime. More than any other area on the body, genital lesions significantly impair patients' psychologic well-being and quality of life. We aimed to systematically review the published evidence on the safety, efficacy, and tolerability of treatments of genital psoriasis and synthesize the available clinical data. A total of 1 randomized controlled trial, 11 open-label studies, and 26 case reports were included in our analysis, representing a total of 458 patients, of which 332 were adults and 126 were children...
August 25, 2018: Dermatology and Therapy
Steven R Feldman, Shipra Rastogi, Jay Lin
INTRODUCTION: Clinical trials have shown brodalumab to have better efficacy than ustekinumab for the treatment of moderate-to-severe psoriasis. An estimation of the cost-effectiveness of brodalumab vs. ustekinumab is warranted and may be useful for treatment decision-making processes, especially in the context of the cost considerations of the current US healthcare system. Therefore, we compared the cost-effectiveness of brodalumab with ustekinumab for treatment of moderate-to-severe psoriasis in biologic-naïve and biologic-experienced patients in the USA...
July 13, 2018: Dermatology and Therapy
Meredith S Steuer, Nina C Botto
INTRODUCTION: Our objectives were to assess patient-reported improvement after patch testing at the 2-3-month follow-up visit in patients referred for patch testing with relevant positive patch test reactions at the University of California, San Francisco. METHODS: Cross-sectional analyses of patients patch tested between 2013 and 2016 who returned for a follow-up visit approximately 2-3 months after patch testing. We examined positive patch test results considered of definite, probable or possible relevance to the patient's eczematous eruptions...
July 9, 2018: Dermatology and Therapy
Hanna Cisoń, Aleksandra Kuś, Ewa Popowicz, Marta Szyca, Adam Reich
Trichotillomania is a chronic, mental disease of impulse control, characterized by repetitive, compulsive, and self-induced hair pulling. It can occur at any age but is observed more often in adolescents, with a strong predominance in females. Diagnosis of trichotillomania may be difficult, and its effective treatment challenging. The aim of this study is to critically review current literature regarding diagnostic procedures and treatment of trichotillomania, including psychotherapy, N-acetylcysteine, naltrexone, topiramate, atypical neuroleptics, and selective serotonin-reuptake inhibitors...
September 2018: Dermatology and Therapy
Leah Conant, Kristen M Beck, Wilson Liao
INTRODUCTION: We describe a novel device for rapid and economical minimal erythema dose testing in patients undergoing ultraviolet (UV) light phototherapy for treatment of skin diseases. METHODS: A minimal erythema testing device was designed and created using transparent plastic sheeting and printed patterns with increasing ink density, allowing for graded UV transmission of 100%, 80%, 60%, 40%, 20%, and 10% energy through six 10-mm square apertures. The plastic sheet was placed in a UV-impenetrable and Velcro-fitted adjustable sleeve, designed to fit easily onto a patient's arm...
September 2018: Dermatology and Therapy
Maria Pia De Padova, Barbara Marzani, Daniela Pinto, Fabio Rinaldi
INTRODUCTION: Actinic keratosis (AKs) are epidermal lesions that commonly occur in skin exposed to chronic cumulative UV irradiation. Untreated AK lesions can advance to squamous cell carcinoma. Current treatments of AK have many shortcomings; for instance, not all treatments can be used for the hyperkeratotic form of AK. The aim of this study was to test the efficacy and tolerability of a topical product containing 2,4,6-octatrienoic acid and urea for the treatment of hyperkeratotic AK lesions...
September 2018: Dermatology and Therapy
Frank Eertmans, Nejib Doss, Bart Rossel, Els Adriaens
INTRODUCTION: Onychomycosis is a fungal nail infection, frequently caused by dermatophytes, which occurs in 2-14% of Western adults. The present study was set up to evaluate the efficacy and safety of a water-based, peelable nail polish (daily application), which acidifies the nail environment, versus a 5% amorolfine nail lacquer (weekly application) for topical treatment of mild-to-moderate onychomycosis. METHODS: One hundred two adults were randomized in this open, prospective, blinded trial...
September 2018: Dermatology and Therapy
Tyler Werbel, Philip R Cohen
INTRODUCTION: 5-Fluorouracil is a fluoropyrimidine antineoplastic medication that is used to topically treat actinic keratoses. Although local adverse effects to the drug are common and anticipated, distant skin reactions are rare and unexpected. In this case report, we describe a patient who developed seborrheic dermatitis-like eruption at a distant site after topical application of 5-fluorouracil to his arms. CASE REPORT: A 63-year-old man with actinic keratoses on his arms developed a facial seborrheic dermatitis-like reaction after topically applying 5-fluorouracil 5% cream twice daily to actinic keratoses on his forearms for 7 days...
September 2018: Dermatology and Therapy
Chiel Cristiano F Ebbelaar, Aalt W Venema, Maria R Van Dijk
INTRODUCTION: Rosacea is a chronic inflammatory skin disease with different phenotypes. There is accumulating evidence that the commensal Demodex mite is linked to papulopustular rosacea. Established treatment options, including topical metronidazole, azelaic acid, and tetracyclines, are thought to work through their anti-inflammatory effects. However, none of these therapies have been shown to be curative and are associated with frequent relapses. Therefore, new and improved treatment options are needed...
September 2018: Dermatology and Therapy
Aileen Y Chang, Edith C Tonui, Douglas Momanyi, Alex R Mills, Paul Wasike, Rakhi Karwa, Toby A Maurer, Sonak D Pastakia
INTRODUCTION: Compression therapy is well-established standard of care for chronic leg ulcers from venous disease and lymphedema. Chronic leg ulcers and lymphedema have a significant impact on quality of life, driven by pain, foul odor, and restricted mobility. Provision of layered compression therapy in resource-limited settings, as in Western Kenya and other regions of sub-Saharan Africa, is a major challenge due to several barriers: availability, affordability, and access to healthcare facilities...
September 2018: Dermatology and Therapy
Barbara J Cohen, Eliahou S Cohen, Philip R Cohen
In this article, the first coauthor, a patient with a basal cell carcinoma on her upper lip, discusses her experience with Mohs micrographic surgery for the treatment of the skin cancer. The second coauthor, who is the patient's physician (a dermatologist who shares her last name but is not a relative), diagnosed her skin cancer and referred her for Mohs surgery. The third coauthor, who is the patient's son and not only a dermatologist, but also a dermatopathologist and a Mohs surgeon (and also shares her last name), summarizes the presentation and treatment of the basal cell carcinoma...
September 2018: Dermatology and Therapy
Elaine C Siegfried, Jennifer C Jaworski, Paola Mina-Osorio
INTRODUCTION: Treatment guidelines endorse a variety of strategies for atopic dermatitis (AD) which may vary from published data and clinical practice patterns. The objective of this review was to quantify the volume of available medical literature supporting pediatric AD treatments and compare these patterns to those recommended by published guidelines and/or clinical practice patterns. METHODS: Searches of Embase (2005-2016) and abstracts from selected meetings (2014-2016) related to AD treatment in patients younger than 17 years of age yielded references that were assessed by study design, primary treatment, age groups, and AD severity...
September 2018: Dermatology and Therapy
Mario Puviani, Massimo Milani
INTRODUCTION: Lesion and field-targeted treatments of actinic keratosis (AK) are commonly indicated for grade I and II type lesions. Grade III lesions are in general more difficult to treat. A film-forming medical device containing piroxicam 0.8% and sunscreen (SPF 50+) (PS) has been shown to be effective in the treatment of grade I and II AK lesions. Topical and oral retinoids have been utilized in AK and non-melanoma skin cancers. Topical glycolic acid promotes keratolysis and stimulates collagen synthesis for repair and skin rejuvenation and could be useful in AK treatment strategies...
September 2018: Dermatology and Therapy
Claudia Costa, Alessia Villani, Daniela Russo, Milena Cappello, Gaia De Fata Salvatores, Massimiliano Scalvenzi
Lichen planus (LP) is a chronic inflammatory disease that affects the skin and oral mucosa. Although its etiology is unknown, its potential for cancerization has been confirmed. We herein report the cases of a brother and sister, both with a 15-year history of nail lichen planus of the fingers and toes, who developed squamous cell carcinomas of the nail bed and matrix. This article shows the potential for malignant transformation in lichen planus disease and highlights the importance of periodic clinical follow-up...
September 2018: Dermatology and Therapy
Paolo Daniele Pigatto, Marco Diani
INTRODUCTION: Atopic dermatitis (AD) is a common chronic inflammatory skin disease; it requires long-term treatments focused on symptomatic relief. Current first-line treatments include moisturizers and topical corticosteroids. Recently, topical antioxidants have been added to moisturizer formulations to alleviate mild-to-moderate AD. The aim of this review was to evaluate the efficacy and tolerability of furfuryl palmitate, a new antioxidant molecule, and furfuryl derivatives. METHODS: A PubMed/Google Scholar search was conducted using the term "furfuryl palmitate" (and its derivatives, including AR-GG27® ) combined with "skin," "atopic dermatitis," and "atopic eczema...
September 2018: Dermatology and Therapy
Torsten Skov, Eggert Stockfleth, Rolf-Markus Szeimies, Brian Berman
INTRODUCTION: Actinic keratosis is regarded as a chronic disease of the skin and, although fluctuating, is chronically progressive. Approval of new products for the treatment of actinic keratosis requires the use of a standard methodology in clinical trials which emphasize complete clearance of all actinic keratoses in a treatment field in a defined time span and the evaluation of long-term efficacy in terms of recurrence rate among completely cleared patients. METHODS: Analysis of data from six previously published clinical trials in patients with actinic keratosis...
June 18, 2018: Dermatology and Therapy
Isabelle M Sanchez, Lindsey Shankle, Marilyn T Wan, Ladan Afifi, Jashin J Wu, Frank Doris, Alisha Bridges, Marc Boas, Brian Lafoy, Sarah Truman, Ana-Maria Orbai, Junko Takeshita, Joel M Gelfand, April W Armstrong, Michael P Siegel, Wilson Liao
INTRODUCTION: To design and implement a novel cloud-based digital platform that allows psoriatic patients and researchers to engage in the research process. METHODS: Citizen Pscientist (CP) was created by the National Psoriasis Foundation (NPF) to support and educate the global psoriatic disease community, where patients and researchers have the ability to analyze data. Psoriatic patients were invited to enroll in CP and contribute health data to a cloud database by responding to a 59-question online survey...
June 6, 2018: Dermatology and Therapy
Julian Trah, Christina Has, Ingrid Hausser, Heinz Kutzner, Konrad Reinshagen, Ingo Königs
The association of junctional epidermolysis bullosa with pyloric atresia (JEB-PA) and aplasia cutis congenita (ACC) was described by El Shafie et al. (J Pediatr Surg 14(4):446-449, 1979) and Carmi et al. (Am J Med Genet 11:319-328, 1982). Most patients die in the first weeks of life, and no curative treatment options are available so far. We describe a patient with JEB-PA and ACC (OMIM # 226730) who was treated for extensive areas of ACC by Integra® -Dermal Regeneration Template and split-thickness skin grafting (STSG)...
June 2018: Dermatology and Therapy
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