Clinical and Experimental Dermatology最新文献

Background: Tralokinumab has demonstrated efficacy in the treatment atopic dermatitis (AD) in both clinical trials and real-world settings. However, limited data exists on the long-term use of tralokinumab in real-world settings.

Objective: A multicentric Italian study, evaluating tralokinumab's drug survival (DS) and efficacy up to 18 months of treatment among 471 patients with severe AD was conducted.

Methods: EASI (Eczema Area and Severity Index), P-NRS (Pruritus Numerical Rating Scale), SD-NRS (Sleep Disturbance NRS), DLQI (Dermatology Life Quality Index) and ADCT (Atopic Dermatitis Control Tool) were recorded up to 18 months of treatment. DS was analyzed using Kaplan-Meier methodic.

Results: Overall DS rate was 81.5% at 12 months. A significant higher DS was found for females (p<0.001, log-rank=11.90), patients with negative family history (FH) of AD (p=0.015, log-rank=5.96) and patients ≥60-year-old (p=0.018; log-rank=5.6) when considering DS due to inefficacy. The study demonstrates a significant reduction in the clinical scores evaluated, with patients naïve to biologics or Janus kinase inhibitors (JAKi) showing a faster improvement. In the univariate regression analysis, females (p=0.038, OR=1.613; C.I. 1.026-2.534), having no atopic comorbidity (p=0.039; OR=1.692; C.I. 1.027-2.783), negative FH of AD (p=0.031; OR=1.665; C.I. 1.047-2.649) and not using concomitant systemic treatment in the previous months (p=0.003; OR=22.065; C.I. 2.803-173.691) were associated with an increased likelihood of reaching EASI-75. In the multivariate analysis, only the latter variable remained significant (p=0.004, OR=23.037, C.I. 2.793-190.052).

Conclusion: A significant improvement in clinical scores was observed, with patients naïve to biologics or JAKi experiencing faster progress. Female sex, absence of atopic comorbidities, and a negative FH of AD were linked to a higher likelihood of achieving EASI-75 in the univariate analysis but lost significance in the multivariate analysis. For discontinuation due to inefficacy, patients aged 60 and older, females, and those with a negative FH of AD had significantly better survival rates.

Literature on reconstruction techniques for post-Mohs nasal defects with particular emphasis on the unique properties of underlying skin is lacking. We aimed to develop an algorithm to simplify the approach to post-Mohs reconstruction of the nose based on defect size, location, and cutaneous features of the surrounding skin. Retrospective review of 404 patients who underwent post-Mohs nasal reconstruction by a single Mohs surgeon between 2018 and 2024 was conducted. Defects were divided into small, medium, and large sizes. Locations were categorized into 3 zones based on cutaneous characteristics. Frequency of reconstructive techniques based on defect size and location was analyzed. Trends towards specific repairs based on the cutaneous location and size of Mohs defects were utilized to develop an algorithm for reconstructive decision making. This algorithm was based on zones defined by cutaneous characteristics, and may serve as an initial guide for surgeons planning reconstruction of nasal defects.

Objectives: Eosinophilic pustular folliculitis (EPF) is an uncommon skin condition that presents as follicular papules or pustules. The treatment of EPF is challenging due to the high relapse rates. This study aimed to evaluate the efficacy and safety of tofacitinib as a treatment for EPF.

Methods: We presented 3 patients with refractory EPF who had been successfully treated with tofacitinib at our clinic and conducted a literature review using the PubMed database to gain further insight into this promising therapy.

Results: Our patients were effectively treated with tofacitinib. To date, only three patients with EPF treated with Janus kinase (JAK) inhibitors have been reported and reviewed: one treated with tofacitinib and two with abrocitinib. Complete remission was observed in all the above patients, with no adverse events or relapses reported during an average follow-up period of 4.3 months.

Conclusion: Tofacitinib may be an emerging alternative treatment option for EFP patients. Larger randomized controlled studies are needed to confirm these findings.

Flat wasps of the genera Sclerodermus and Cephalonomia (Hymenoptera: Bethylidae) are ectoparasitoids of larvae from various insect orders. They are important biological control agents against stored-product insect pests and xylophagous insects. In humans, these genera encompass species that are responsible for the emergence of sting lesions worldwide. Despite their importance for human health, there are very few reports in the literature that provide a comprehensive overview of this topic. This review, based on literature data and authors' personal experience, describes skin lesions induced by insect species belonging to the Sclerodermus and Cephalonomia genera, focusing on possible involved pathomechanism, diagnosis, therapeutic management, and environmental disinfestation.