Clinical and Experimental Dermatology最新文献

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug-induced hypersensitivity reaction often requiring prolonged corticosteroid (CS) therapy, yet tapering is difficult due to relapse. This retrospective single-center case series evaluated the efficacy and safety of selective JAK inhibitors in facilitating CS tapering in moderate-to-severe, refractory DRESS, and in ameliorating pruritis. Six patients (median age 35 years; five females) received baricitinib or abrocitinib with CS between July 2023 and June 2024. All achieved rapid clinical improvement, with generalized lesion resolution and pruritus reduction by more than three WI-NRS points. Successful initial CS tapering occurred within 7∼12 days, and four patients discontinued CS completely within 28∼62 days, two stayed with low-dose CS due to primary autoimmune disease. Serum cytokines, particularly interleukin-5, decreased markedly after JAK inhibition. No severe adverse events occurred, including in patients with pancytopenia or hepatic dysfunction. JAK inhibitors appear effective and well-tolerated in promoting CS tapering in refractory DRESS, suggesting larger controlled studies are needed.

Background: In countries with well-resourced primary care, most children with eczema are managed by their General Practitioner (GP) but we know little about how often they are seen or how they are treated.

Objectives: To describe patterns of consultations and prescribing by eczema severity for children with eczema.

Methods: Analysis of electronic medical record data from 422/483 participants in the BATHE study. We used descriptive statistics to compare participants characteristics, consultation and prescribing patterns. We explored associations with eczema severity (POEM), age and gender using Poisson and linear regression models.

Results: Mean (SD) age 4.8 (2.9) years and POEM 10.0 (5.8). Over 12 months, 386 children had a median (IQR) of 4.0 (2-7) consultations. Of 2049 encounters, 1421 (69.4%) were for an eczema flare. Emollients were the most commonly prescribed item, with a mean of 4.6 prescriptions (507.9 g/ml) per child, yet 32.0% were not prescribed any. On average, children were prescribed 1.3 different emollient-types, with cream being most common (79.5% children, 66.5% prescriptions). 51.4% were prescribed a topical corticosteroid (TCS) with a mean of 2.8 prescriptions (50.6 g) per child and a mean of 1.4 different TCS potency-types (mild being the most common 73.3% children, 56.7% prescriptions). Number of consultations but not quantity of emollients and TCS prescribed were associated to age and eczema severity.

Conclusions: Children with eczema are seen frequently in primary care but are prescribed less emollient and TCS than might be appropriate for age and severity.

Psoriasis and psoriatic arthritis (PsA) are chronic inflammatory diseases, affecting patients' quality of life, particularly when involving difficult-to-treat areas. While randomized controlled trials (RCTs) have shown that ixekizumab is effective for psoriatic disease, real-world evidence (RWE) is essential for assessing its broader applicability. This retrospective, single-center study evaluated the effectiveness and safety of ixekizumab in 37 Greek patients with psoriasis and/or PsA, including involvement of difficult-to-treat areas, over 52 weeks of treatment. Ixekizumab led to significant and sustained improvements in skin disease up to week 52. Joint manifestations and difficult sites showed marked improvement, as did patient-reported quality of life. Biologic-naïve patients and those with early disease onset showed better responses. No serious adverse events were reported, and cardiovascular parameters remained stable. These findings support ixekizumab's strong efficacy and safety in routine clinical use, including patients with prior biologic exposure and complex disease, reinforcing its role as a cornerstone therapy.