Clinical and Experimental Dermatology最新文献

Primary hyperhidrosis is associated with a substantial mental burden. In this study, the objective was to compare the occurrence of psychiatric diseases in individuals with and without primary hyperhidrosis by systematically reviewing the literature and conducting a meta-analysis. The PRISMA statement and the MOOSE checklist were employed. Cochrane Library, Embase and PubMed were searched. The risk of bias was determined by the Newcastle-Ottawa Scale. A random effects model was employed in the meta-analysis. Fifteen studies met the eligibility criteria, encompassing 50 429 participants with hyperhidrosis and 182 464 control participants. Hyperhidrosis was associated with increased odds of anxiety (odds ratio 3.5, 95% confidence interval 1.0-11.8) and depression (odds ratio 2.4, 95% confidence interval 1.4-4.0). Studies using outcome definitions for anxiety and depression and not included in the meta-analysis showed similar results. Studies reporting on other morbidities (i.e. body dysmorphic disorder, social phobia and stress) found a higher occurrence of these outcomes in the individuals with hyperhidrosis than in the control participants. Primary hyperhidrosis is associated with anxiety and depression. These results acknowledge the psychiatric burden that patients with primary hyperhidrosis experience.

Background: Real-world data regarding the use of dupilumab in children with atopic dermatitis (AD) are limited.

Objectives: To evaluate the real-world efficacy of dupilumab in children with moderate-to-severe AD over an extended follow-up period.

Methods: This was a retrospective study of patients (≤ 18 years) with moderate-to-severe AD treated with dupilumab in four Israeli tertiary centres. Efficacy and safety were assessed using descriptive statistics.

Results: In total, 230 patients were included in the analysis [age 9.9 years (SD 4.3), male/female 1 : 1 ratio)]. Of them, 59.6% (137/230) had ≥ 1 atopic comorbidity. The follow-up duration ranged from 2 to 248 weeks, with a median of 52 weeks (interquartile range 24-96). Within 12 weeks of treatment, 41.7% (68/163) of patients had reached Investigator Global Assessment 0-1. The mean body surface area was reduced from 58.0% (SD 20.5%) at baseline to 27.8% (SD 20.2%) at 12 weeks. The average Pruritus Numeric Rating Scale score was reduced from 7.9 (SD 2.2) at baseline to 2.3 (SD 2.8) at 12 weeks. Adverse events, in 210 patients, included conjunctivitis in 34 patients (16.2%), injection-site reactions in 11 patients (5.2%) and dupilumab-associated head and neck dermatitis in 6 patients (2.9%). Overall, 26 of 210 patients (12.3%) discontinued the treatment: 9 of the 26 patients (35%) because of adverse events and 15 patients (58%) because of inadequate efficacy. The overall probability of dupilumab survival at 52 weeks was 94.0%.

Conclusions: Real-world data presented here for 230 paediatric and adolescents with moderate-to-severe AD reinforce dupilumab's efficacy and safety and highlight dupilumab's high survival rate after 1 year of treatment in the paediatric population.

Cutaneous neoplasms are relatively rare in children. Most commonly, skin cancers arise through environmental factors, particularly ultraviolet radiation; thus, age is the most predictive factor in developing cutaneous carcinomas. However, children born with certain genodermatoses are significantly more likely to develop malignancies and must be carefully monitored and treated. Most published data are based mainly on signs and symptoms present in White patients. Therefore, we aim to highlight the cutaneous presentations and relative differences of these genodermatoses among patients with skin of colour, who are underrepresented in medicine. We conducted a literature review of 504 patients presented in 236 published articles. Manuscripts with accessible case reports for children aged ≤ 17 years were included. Patients with skin of colour often present with fewer classical findings and have higher incidences of scarring and dyspigmentation. There is also a higher incidence of consanguinity in affected patients. Providers who are able to recognize nonclassical signs can provide proper management and treatment regimens, potentially bringing outcomes for patients with skin of colour more in line with those of White children.

Fatal outcomes in drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) are reported to be associated with cytomegalovirus (CMV) reactivation. However, CMV reactivation is observed not only in DIHS/DRESS but also in other diseases when high doses of corticosteroids are administered. Currently, it is difficult to distinguish whether CMV reactivation in DIHS/DRESS is caused by steroid-induced immunosuppression or the pathology of DIHS/DRESS. In this study, we describe the characteristic of CMV reactivation in patients with DIHS/DRESS (n = 22) by comparing the frequency of reactivation and its complications with those that occur in people with pemphigus vulgaris (PV) (n = 21) treated with high doses of corticosteroids. The frequency of CMV reactivation showed no difference between the DIHS/DRESS and PV groups. On the other hand, the frequency of CMV complications was higher in the DIHS than the PV group. Our data show the importance of monitoring for CMV complications, although CMV reactivation is not a unique consequence of DIHS/DRESS compared with other diseases treated with a high dose of corticosteroids.