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Neutrophilic Dermatosis and Management Strategies for the Inpatient Dermatologist. 皮肤科住院医生的嗜中性皮肤病和管理策略。
IF 2.4 Q2 DERMATOLOGY Pub Date : 2022-01-01 Epub Date: 2022-07-16 DOI: 10.1007/s13671-022-00364-7
Nishi Shah, Maria S Asdourian, Ted V Jacoby, Steven T Chen

Purpose of review: Neutrophilic dermatoses are a heterogeneous group of disorders with significant overlap in associated conditions, clinical presentation, and histopathologic features. This review provides a structural overview of neutrophilic dermatoses that may present in the inpatient setting along with diagnostic work-up and management strategies.

Recent findings: Sweet's syndrome has been found in patients with coronavirus disease 2019 (COVID-19). Pyoderma gangrenosum (PG) has been shown to be equally associated with ulcerative colitis and Crohn's disease. A clinical trial shows that cyclosporine is equally effective as prednisone in treating PG. Neutrophilic eccrine hidradenitis has been found in the setting of newer antineoplastic medications, such as BRAF inhibitors, as well as in the setting of malignancy without chemotherapy exposure.

Summary: Neutrophilic dermatoses are a rare and complex group of dermatoses with varying and overlapping clinical presentations. Physicians should be aware of the growing list of associated diseases in order to build a better differential diagnosis or to potentially investigate for co-existing disease.

综述目的:嗜中性粒细胞皮肤病是一组异质性疾病,在相关疾病、临床表现和组织病理学特征方面存在明显重叠。本综述从结构上概述了可能在住院环境中出现的嗜中性皮肤病,以及诊断工作和管理策略:在冠状病毒病 2019(COVID-19)患者中发现了斯威特综合征。脓皮病(PG)已被证明与溃疡性结肠炎和克罗恩病同样相关。一项临床试验显示,环孢素与泼尼松对治疗脓皮病同样有效。在使用 BRAF 抑制剂等新型抗肿瘤药物以及未接受化疗的恶性肿瘤患者中也发现了中性粒细胞性皮炎。医生应了解越来越多的相关疾病,以便更好地进行鉴别诊断或对并存疾病进行潜在调查。
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引用次数: 0
Contact Urticaria Syndrome: a Comprehensive Review. 接触性荨麻疹综合征:全面回顾。
IF 2.4 Q2 DERMATOLOGY Pub Date : 2022-01-01 Epub Date: 2022-11-18 DOI: 10.1007/s13671-022-00379-0
Ana M Giménez-Arnau, David Pesqué, Howard I Maibach

Purpose of review: Contact urticaria syndrome includes contact urticaria and protein contact dermatitis. Underreport, underdiagnosis, or misdiagnosis of entities within the contact urticaria syndrome is believed to be common, especially in the occupational setting. This review provides a structured overview of the entities comprised in this syndrome as well as the diagnostic work-up and management strategies.

Recent findings: Contact urticaria syndrome has been increasingly described due to personal protective equipment and hand sanitizers in the context of the COVID-19 pandemic. The use of legal cannabis products has led to a rise in occupational cases of contact urticaria to cannabis. A declining trend in the evolution of contact urticaria has been described for natural rubber latex allergy due to the use of synthetic gloves. Prick test has been proposed as a screening method, particularly if multiple products are to be tested, instead of the classical sequential scheme.

Summary: Physicians should be aware of the growing number of culprit agents leading to contact urticaria syndrome. Clinical presentation may be challenging since it includes immediate urticaria and/or eczema and even more generalized reactions. Diagnosis requires a high degree of suspicion, detailed occupational history, and complementary tests, including skin testing. The best treatment is to avoid contact with the culprit agent and to implement preventive measures.

审查目的:接触性荨麻疹综合征包括接触性荨麻疹和蛋白接触性皮炎。据信,接触性荨麻疹综合征中的实体报告不足、诊断不足或误诊的情况很常见,尤其是在职业环境中。本综述对接触性荨麻疹综合征所包含的实体以及诊断工作和管理策略进行了结构化概述:在 COVID-19 大流行的背景下,接触性荨麻疹综合症的病因越来越多地归咎于个人防护设备和洗手液。合法大麻产品的使用导致了大麻接触性荨麻疹职业病例的增加。由于合成手套的使用,对天然橡胶乳胶过敏的接触性荨麻疹病例呈下降趋势。总结:医生应意识到导致接触性荨麻疹综合征的致病因子越来越多。临床表现可能具有挑战性,因为它包括即时性荨麻疹和/或湿疹,甚至更广泛的反应。诊断需要高度怀疑、详细的职业史和辅助检查,包括皮肤测试。最好的治疗方法是避免接触致病因子并采取预防措施。
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引用次数: 0
Impact of the COVID-19 Pandemic on the Delivery of Dermatological Care. COVID-19大流行对皮肤科护理提供的影响。
IF 1.6 Q2 DERMATOLOGY Pub Date : 2022-01-01 DOI: 10.1007/s13671-022-00378-1
Alexa B Kimball, Martina L Porter

Purpose of review: We review several important changes affecting dermatology during the COVID-19 pandemic, beginning in March 2020. Specifically, we focus on the impact of the COVID-19 pandemic on physician trends in employment, delivery of care via teledermatology, and burnout, resilience, and wellness.

Recent findings: More physicians are now employed by corporate entities than prior to the pandemic. Teledermatology can be utilized effectively and integrated into current care models; however, the continued use of teledermatology will largely depend on financial compensation. The COVID-19 pandemic was a source of burnout for all physicians, including dermatologists, and impacted how many people view their work.

Summary: The COVID-19 pandemic pushed physicians to change their employment, required them to implement telehealth rapidly, and forced them to re-evaluate their priorities. Prior to the pandemic, more physicians transitioned into employed positions as compared to physician-owned practices. Multiple reasons for consolidation exist, but the trend accelerated during the COVID-19 pandemic for all medical specialties. Similarly, teledermatology was utilized prior to the pandemic, but its use exploded in the early days of the COVID-19 pandemic and continues to this day. The future of teledermatology though depends primarily on insurance reimbursement for these visits as well as both patient and physician preferences for continued usage. Lastly, wellness became a major focus in medicine as the pandemic took a significant toll on physicians, including dermatologists.

回顾目的:我们回顾了自2020年3月开始的COVID-19大流行期间影响皮肤病学的几项重要变化。具体而言,我们重点关注2019冠状病毒病大流行对医生就业趋势、通过远程皮肤科提供护理以及职业倦怠、恢复力和健康的影响。最近的调查结果:与大流行之前相比,现在有更多的医生受雇于公司实体。远程皮肤病学可以有效地利用并融入当前的护理模式;然而,远程皮肤科的继续使用将在很大程度上取决于经济补偿。COVID-19大流行是包括皮肤科医生在内的所有医生精疲力竭的一个原因,并影响了许多人对自己工作的看法。总结:2019冠状病毒病大流行迫使医生改变职业,要求他们迅速实施远程医疗,并迫使他们重新评估自己的优先事项。在大流行之前,与医生拥有的做法相比,更多的医生转变为就业岗位。合并的原因有很多,但在2019冠状病毒病大流行期间,所有医学专业的合并趋势都加速了。同样,远程皮肤病学在大流行之前就得到了利用,但在COVID-19大流行的早期,其使用激增,并一直持续到今天。远程皮肤病学的未来主要取决于这些访问的保险报销以及患者和医生对继续使用的偏好。最后,健康成为医学的一个主要焦点,因为大流行给包括皮肤科医生在内的医生造成了重大损失。
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引用次数: 3
Outpatient Management of COVID-19: A Primer for the Dermatologist. COVID-19 的门诊管理:皮肤科医生入门指南》。
IF 2.4 Q2 DERMATOLOGY Pub Date : 2022-01-01 Epub Date: 2022-08-20 DOI: 10.1007/s13671-022-00368-3
Sonia Wang, Joel M Gelfand, Cassandra Calabrese

Purpose of review: To summarize diagnostic and therapeutic management of COVID-19 in the outpatient setting for dermatologists.

Recent findings: Paxlovid (nirmatrelvir-ritonavir) is the preferred treatment in patients with mild symptoms at high risk of progression to severe SARS-CoV2 infection. Additional options include monoclonal antibodies (bebtelovimab), remdesivir, and molnupiravir.

Summary: Dermatologists need to be aware of recent developments in diagnostic and therapeutic management of COVID-19 in the outpatient setting, as their patients may rely on dermatologists to provide advice, particularly in cases where treatments for dermatological disease may impact the risk of COVID-19 and/or vaccine efficacy.

Supplementary information: The online version contains supplementary material available at 10.1007/s13671-022-00368-3.

综述目的:总结皮肤科医生在门诊环境中对 COVID-19 的诊断和治疗方法:最近的研究结果:对于症状轻微、极有可能发展为严重SARS-CoV2感染的患者,Paxlovid(nirmatrelvir-ritonavir)是首选治疗药物。小结:皮肤科医生需要了解门诊COVID-19诊断和治疗方面的最新进展,因为他们的病人可能需要皮肤科医生提供建议,尤其是在皮肤病治疗可能影响COVID-19风险和/或疫苗疗效的情况下:在线版本包含补充材料,可在 10.1007/s13671-022-00368-3上查阅。
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引用次数: 0
SARS-CoV-2 Infection and Vaccination Cutaneous Manifestations for the Inpatient Dermatologist. SARS-CoV-2感染与疫苗接种住院皮肤科医生的皮肤表现
IF 1.6 Q2 DERMATOLOGY Pub Date : 2022-01-01 DOI: 10.1007/s13671-022-00374-5
Sonia Himed, Ashley Gray, Zaynah Awethe, Karissa Libson, Benjamin H Kaffenberger, Abraham M Korman, John C L Trinidad

Purpose of review: The overall purpose of this review was to characterize and summarize cutaneous eruptions associated with coronavirus disease 2019 (COVID-19) as well as COVID-19 vaccination.

Recent findings: Cutaneous eruptions associated with COVID-19 infection have a reported frequency of 1-20%. Increased COVID-19 disease severity has been associated with morbilliform exanthems, urticaria, retiform purpura, and livedo racemosa. Papulovesicular eruptions were associated with a milder COVID-19 disease course. A range of dermatoses have also been reported with COVID-19 vaccination but have rarely prevented subsequent vaccination.

Summary: Dermatologists should be aware of the associations between COVID-19 disease severity and cutaneous eruptions. Livedo racemosa and retiform purpura are particularly associated with increased disease severity and death. In the setting of COVID-19 vaccination, cutaneous eruptions can largely be managed symptomatically and very rarely do these reactions prevent subsequent vaccination.

综述目的:本综述的总体目的是描述和总结与2019冠状病毒病(COVID-19)相关的皮肤皮疹以及COVID-19疫苗接种。最近发现:据报道,与COVID-19感染相关的皮肤皮疹发生率为1-20%。增加的COVID-19疾病严重程度与麻疹样疹、荨麻疹、网状紫癜和活状红斑有关。丘疹水疱性爆发与较轻的COVID-19病程相关。据报道,在接种COVID-19疫苗后也出现了一系列皮肤病,但很少阻止后续接种。总结:皮肤科医生应该意识到COVID-19疾病严重程度与皮肤爆发之间的关联。总形紫癜和网状紫癜尤其与疾病严重程度和死亡增加有关。在接种COVID-19疫苗的情况下,皮肤皮疹基本上可以对症处理,这些反应很少妨碍后续的疫苗接种。
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引用次数: 0
Off-Label Uses of Rituximab in Dermatology. 利妥昔单抗在皮肤病学中的超说明书使用。
IF 1.6 Q2 DERMATOLOGY Pub Date : 2022-01-01 DOI: 10.1007/s13671-022-00375-4
Connor Cole, Kyle T Amber

Purpose of review: Rituximab has transformed the treatment of B-cell malignancies and rheumatoid arthritis in the past 2 decades. More recently, this anti-CD20 monoclonal antibody has seen increasing usage in the field of dermatology. This review highlights the evidence supporting its use in several important dermatologic conditions.

Recent findings: Key recent findings include the 2018 FDA approval of rituximab for the treatment of moderate-to-severe pemphigus.

Summary: Data from randomized controlled trials have demonstrated the efficacy of rituximab in pemphigus, ANCA-associated vasculitis, and cryoglobulinemic vasculitis. More limited data suggests its use in recalcitrant cases of diseases such as pemphigoid, epidermolysis bullosa acquisita, and dermatomyositis. There is scarce evidence and mixed results for rituximab when studied in cutaneous polyarteritis nodosa and cutaneous lupus erythematosus.

回顾目的:在过去的20年里,利妥昔单抗已经改变了b细胞恶性肿瘤和类风湿关节炎的治疗。最近,这种抗cd20单克隆抗体在皮肤病学领域的应用越来越广泛。本综述强调了支持其在几种重要皮肤病中使用的证据。最近的主要发现包括2018年FDA批准利妥昔单抗治疗中重度天疱疮。摘要:来自随机对照试验的数据已经证明了美罗华治疗天疱疮、anca相关血管炎和冷球蛋白性血管炎的疗效。更有限的数据表明,它用于顽固性疾病,如类天疱疮、获得性大疱性表皮松解症和皮肌炎。当研究皮肤结节性多动脉炎和皮肤红斑狼疮时,利妥昔单抗缺乏证据和混合结果。
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引用次数: 1
Allergic Contact Dermatitis to Corticosteroids 皮质类固醇致过敏性接触性皮炎
IF 1.6 Q2 DERMATOLOGY Pub Date : 2021-11-24 DOI: 10.1007/s13671-021-00338-1
Alison Spurr, M. Pratt, Shaghayegh Shahrigharahkoshan
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引用次数: 1
Emerging Treatment Options for Rosacea 新出现的酒渣鼻治疗方案
IF 1.6 Q2 DERMATOLOGY Pub Date : 2021-11-02 DOI: 10.1007/s13671-021-00347-0
P. Naik
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引用次数: 0
Patch Testing and Immunosuppression: a Comprehensive Review 斑贴试验和免疫抑制:综述
IF 1.6 Q2 DERMATOLOGY Pub Date : 2021-10-30 DOI: 10.1007/s13671-021-00346-1
B. Levian, Justin Chan, V. Deleo, B. Adler
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引用次数: 1
Contact Dermatitis to Nail Cosmetics 指甲化妆品接触性皮炎
IF 1.6 Q2 DERMATOLOGY Pub Date : 2021-10-19 DOI: 10.1007/s13671-021-00345-2
R. Calado, T. Gomes, A. Matos, M. Gonçalo
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引用次数: 1
期刊
Current Dermatology Reports
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