Dermatologic Therapy最新文献

Background: Chronic inflammation has been implicated in hypertrophic scar (HS) formation based on experimental evidence and clinical observations. However, the existence of a causal relationship between circulating cytokines and the risk of HS remains uncertain. This study aimed to elucidate whether genetically predicted circulating cytokine levels are associated with HS risk using a two-sample Mendelian randomization (MR) analysis.

Methods: We used genetic variants associated with circulating levels of cytokines in a genome-wide association study (GWAS) meta-analysis involving 8293 European populations as instrumental variables. HS data were obtained from an open GWAS dataset comprising 208,248 individuals of European descent, including 766 diagnosed HS cases and 207,482 controls. Analysis was performed using MR methods including inverse-variance weighted (IVW), MR-Egger, weighted median, simple median, and weighted mode. The MR-Egger intercept and Cochran’s Q test were applied to assess pleiotropy and heterogeneity, and MR Steiger test was employed to examine the causative direction.

Results: Our findings revealed a suggestive causal relationship between elevated circulating levels of interleukin-2 (IL-2) and an increased risk of HS (OR: 1.48, 95% CI: 1.04–2.10, p = 0.028); platelet-derived growth factor-BB (PDGFbb) was also causally associated with the risk of HS (OR: 1.38, 95% CI: 1.07–1.77, p = 0.012).

Conclusion: Our MR analysis provides suggestive evidence supporting a potential causal relationship between circulating IL-2, PDGFbb, and HS risk. Further research is warranted to explore how these cytokines influence the development of HS.

Background: GR1802 is a newly developed, fully humanized monoclonal antibody targeting the interleukin-4 receptor alpha (IL-4Rα) subunit, which is a component common to both the IL-4 and IL-13 receptor complexes.

Objectives: Our objective was to assess the efficacy of GR1802 in adult patients presenting with moderate-to-severe atopic dermatitis.

Methods: In this clinical trial, patients with moderate-to-severe atopic dermatitis were randomly assigned to receive either 300 mg GR1802, 150 mg GR1802, or a placebo every 2 weeks for 16 weeks. Primary endpoints were the Eczema Area and Severity Index (EASI-75) response rates at Week 16. Secondary efficacy outcomes included responders at various evaluation points from baseline to study end: IGA 0/1 with ≥ 2-point improvement; EASI-75, EASI-90, and EASI-50; and ≥ 3- or ≥ 4-point improvements in weekly average daily PP-NRS score. Safety was evaluated throughout the study.

Results: From August 2022 to February 2023, 120 patients were randomized to receive either GR1802 150 mg (n = 40), GR1802 300 mg (n = 40), or placebo (n = 40), with 107 completing the study. GR1802 demonstrated a higher proportion of patients achieving EASI-75 at Week 16 compared with the placebo group, and the observed differences in EASI-75 response rates were 39.1% (GR1802 300 mg vs. placebo, 95% CI 20.0–58.2, p = 0.0002) and 19.4% (GR1802 150 mg vs. placebo, 95% CI −0.8–39.7, p = 0.0740). The GR1802 300 mg group also showed greater efficacy on secondary endpoints compared to the GR1802 150 mg group. Serious adverse events occurred in 10% of placebo patients, 2.5% of the GR1802 150 mg group, and none in the GR1802 300 mg group. Treatment-emergent AEs occurred in 75.0% of the GR1802 150 mg group, 82.5% of the GR1802 300 mg group, and 85.0% of the placebo group.

Conclusions: GR1802 was well tolerated and effective in moderate-to-severe AD patients, showing a dose–response trend at 150–300 mg.

Trial Registration: Chinese Registry of Clinical Trials: ChiCTR2100051917

Background: A notable trend has been observed toward procedural interventions for periorbital hyperpigmentation (POH), with a variety of pharmacological and nonpharmacological treatment modalities being introduced. This systematic review aims to provide a comprehensive evaluation of these diverse procedural treatments for POH in the medical literature.

Method: A systematic search was performed in major databases up to 2023, and studies were evaluated for clinical improvement, patient satisfaction, and adverse events. The retrieved studies were categorized as lasers and light therapies, chemical peels, PRP, carboxytherapy, fillers and injections, microneedling, and combination therapies.

Results: A total of 33 studies involving 1320 patients were evaluated. The meta-analysis of improvement rates revealed that lasers (fractional CO₂ and Q-switched or long-pulsed Nd: YAG) and combination treatments (microneedling + chemical peels or fillers + lasers) demonstrated the highest efficacy, with 82% and 75% of patients experiencing excellent or good (> 50%) improvement, respectively. Chemical peels, carboxytherapy, and PRP were less effective, benefiting 63%, 54%, and 44% of patients in the same category, respectively. Although fillers and autologous fat injections showed marked improvement in 94% and 74% of patients, the comparison of their results was limited due to their representation by a single study in each category. Considering the meta-analysis of satisfaction rates, lasers and combination treatments also led, with 82% and 75% of patients expressing over 50% satisfaction with treatment, respectively. Adverse events were generally mild and transient across treatments. Common side effects of lasers included transient burning and erythema. The fractional CO₂ laser was associated with discomfort, pain, and edema, with a shorter duration of swelling and erythema when combined with PRP. Q-switched and picosecond Nd:YAG lasers had higher postinflammatory hyperpigmentation rates compared to carboxytherapy and the picosecond 755-nm laser. The most common adverse effect of chemical peeling was erythema, with glycolic acid showing the maximum incidence.

Conclusion: This systematic review reveals that lasers and combination therapies are the most effective and satisfactory treatments for POH, with generally mild and transient adverse events. However, further studies comprising larger sample sizes, multiple-arm designs, and longer follow-ups are needed to enable more robust comparisons.

Background: In patients with atopic eczema (AE), phototherapy is often combined with topical therapy in order to achieve better disease control. While commonly used guidelines do recommend concomitant use of ointments, creams and ultraviolet (UV) radiation, details on how to apply a topical regimen in combination with phototherapy in an effective, safe and tolerable manner are currently not provided. This systematic review assesses the available evidence on whether and how the several types of topical therapies can be effectively and safely used in combination with phototherapy in the treatment of AE.

Methods: An update of a 2021 Cochrane review’s search was conducted. Randomised controlled trials (RCTs) were included that studied the treatment of AE with phototherapy in one or more study arms, to ensure no RCTs that allowed for the concomitant use of topicals would be missed. Two authors performed study selection and extraction of topical therapy data.

Results: A total of 33 studies were included. Twenty-nine studies reported on combining topical therapy with phototherapy. Of these studies, all allowed for the concomitant use of emollients, 13 allowed topical corticosteroids and 1 allowed a topical calcineurin inhibitor. One study investigated the efficacy of combining phototherapy and a topical agent. None of the remaining studies commented on the efficacy of combination therapy. Nine studies included details on the frequency of the use of topicals. Three studies reported on timing of emollients with regard to phototherapy. Six studies reported a topical base type (cream, ointment, jelly). No studies reported on safety. Risk of bias was assessed as ‘high’or as ‘some concerns’.

Conclusions: Very limited data from RCTs exist on the efficacy, safety and methods of combining topical therapy with phototherapy in the treatment of AE. This results in a lack of detailed guidance on how to perform combination therapy, which is striking as the combination of topicals and UV is widely applied in daily practice.

Acne is a common disease worldwide, predominantly occurring in teenagers. Commonly prescribed therapies often cause adverse effects and in case of antibiotics bare the risk of developing resistances. Cold atmospheric plasma (CAP) is a well-tolerable, physical treatment method, which is well established in the treatment of chronic wounds since it provides bactericidal and wound healing properties. Our aim was to evaluate the efficacy and safety of CAP as a potential add-on therapy for mild acne papulopustulosa in a randomized controlled, double-blind pilot study. Forty participants were randomized into two arms of 20 each. Both groups self-applied 0.1% of adapalene cream daily and received weekly skin-cleansing by a physician combined with either CAP verum-device treatments or placebo-device applications instead. The endpoint of the treatment segment was at 6, and follow-up was at 10 weeks. The co-primary endpoints total inflammatory lesion count (TILC) and acne-specific Investigator Global Assessment (IGA) score as well as secondary endpoints sebumetry, total porphyrin count (TPC) reflecting Cutibacterium acnes colonization, and occurrence of adverse events (AEs) were measured from baseline until follow-up, while the Acne-specific Quality of Life (AQOL) questionnaire was assessed at baseline and endpoint. TILC decreased greater in the verum versus control group from baseline (45.8 vs. 49.4) toward endpoint (22.1 vs. 38.6; p = 0.07) to follow-up (16.5 vs. 28.7; p = 0.48), matched by the IGA score with similarly greater improvement in the verum versus control group from baseline (2.3 vs. 2.6) to endpoint (1.3 vs. 2.3; p <  0.001) until follow-up (1.0 vs. 1.9; p = 0.006). Sebumetry, TPC, and AQOL scores decreased more during treatment and in the verum group. AE occurred less frequently in the verum group without serious AE reported overall (all p < 0.05). Conclusively, CAP proved to be an efficient and well-tolerable add-on therapy for the treatment of mild acne papulopustulosa.

Trial Registration: German Registry of Clinical Trials: DRKS00032416

Background: The increasing utilization of interleukin-17 (IL-17) monoclonal antibody (MA) for psoriasis treatment, coupled with the high prevalence of hepatitis B virus (HBV), underscores the need for comprehensive safety data. This retrospective study aims to evaluate the safety of IL-17 MA treatment in psoriasis patients with concurrent HBV infection.

Research Design and Methods: The study screened 531 psoriasis patients treated with IL-17 MA, ultimately enrolling 59 patients with abnormal HBV serological data. Outcomes assessed include HBV virological reactivation and changes in HBsAb serum quantification post-IL-17 MA therapy.

Results: Laboratory data revealed HBV virological reactivation in two psoriasis patients classified as inactive HBV carriers (IBCs). Patients who had previously received HBV vaccination exhibited a significant decrease in HBsAb serum quantification following IL-17 MA therapy.

Conclusion: IL-17 MA therapy presents a potential risk of HBV reactivation in psoriasis patients with HBV infection. Furthermore, IL-17 MA appears to weaken HBV resistance in vaccinated patients.

Introduction: Plantar warts are common skin lesions caused by HPV that can generate discomfort and impact quality of life. There are several therapeutic options such as cryotherapy or laser, but more high-quality comparative studies are needed.

Methods: A randomized clinical trial was performed with 44 patients with plantar warts who were assigned 22 to each group. Sessions were applied at 1-week intervals evaluating clinical healing, VAS pain scale, and complications.

Results: Laser removed warts in significantly fewer sessions (mean 3.26) than cryotherapy (mean 4.06) (p = 0.022). There were no differences in safety or pain between groups.

Conclusion: Diode laser demonstrated faster removal of plantar warts than cryotherapy, constituting a promising noninvasive alternative. Further studies are needed to confirm its long-term efficacy and safety profile.

Trial Registration: ClinicalTrials.gov identifier: NCT06228521

Dupilumab, a monoclonal antibody targeting interleukin-4 receptor alpha, has shown both robust efficacy and safety in pediatric atopic dermatitis (AD), but data on complete disease control (Eczema Area and Severity Index [EASI] 100) are scarce. A retrospective analysis of 25 pediatric patients at our institution with a median treatment duration of 20 months revealed a significant improvement in EASI scores, with 44.0% achieving EASI 100 at a median of 52 weeks of treatment. No significant differences were found between the group of patients achieving EASI 100 and those who did not. While this study provides additional insight into the efficacy and safety of dupilumab in pediatric AD, its limited sample size underscores the need for larger scale studies focusing on EASI 100 to better understand the factors influencing complete disease control and to optimize treatment strategies for pediatric patients with AD.

Background: Treating lichen planopilaris (LPP) is challenging for dermatologists. Along with anti-inflammatory agents, another goal of treatment is to improve hair thickness in unaffected areas to cover the scars.

Aim: To evaluate the effectiveness and safety of adding low-dose oral minoxidil (OM) to the standard anti-inflammatory treatment of LPP.

Method: A total of 37 patients with LPP were randomly assigned to receive either 15 mg/week methotrexate (MTX) plus topical clobetasol or 1 mg/day minoxidil in addition to MTX plus clobetasol for 6 months. The Lichen Planopilaris Activity Index (LPPAI), dermoscopy, and standard photography evaluated the treatment efficacy.

Results: Both groups exhibited a significant improvement in LPPAI (p < 0.001). The following signs/symptoms demonstrated notable improvements in frequency and/or severity in both groups: pruritus, anagen pull test, follicular prominency, scalp erythema, perifollicular erythema, milky red area, and pigmentation. However, pain, burning sensation, hair tufting, and spreading only improved in the MTX + low-dose OM group. Elongated blood vessels did not improve in either group. In terms of hair thickness and density, there was no significant difference between the two groups.

Conclusion: The addition of 1 mg/day minoxidil to the standard treatment of LPP was found to be safe but did not yield significant effects on LPPAI and hair density/thickness. Notably, two patients who received low-dose OM (2/19, 10.5%) showed hair regrowth in scarring areas. Trials with higher doses of minoxidil may be promising.

Trial Registration: Iranian Registry of Clinical Trials: IRCT20220528055005N1

Introduction: Previous observational studies have shown an association between specific dietary intake and atopic diseases. However, few studies have analyzed the causal effects of dietary factors on risk of atopic diseases. Therefore, we conducted a Mendelian randomization (MR) study to explore these relationships.

Methods: In this study, we obtained summary statistics on dietary intake and atopic diseases including atopic dermatitis, allergic asthma, allergic conjunctivitis, and allergic rhinitis from large genome-wide association studies (GWASs) in European populations. MR analysis was performed using the inverse variance weighted (IVW) method, supplemented with MR Egger, weighted median, maximum likelihood, and weighted model analysis methods.

Results: Our study included 34 diet-related exposure factors. The results indicated that increased intake of filtered coffee could reduce the risk of developing atopic dermatitis. Conversely, higher average monthly intake of other alcoholic drinks was associated with an increased risk of atopic dermatitis. For allergic asthma, higher intake of filtered coffee was identified as a protective factor, while increased average weekly intake of spirits and cherry were considered risk factors. Furthermore, an increase in average weekly intake of beer plus cider was found to potentially lower the risk of allergic conjunctivitis. However, we did not discover any causal association between the risk of allergic rhinitis and the dietary intake factors.

Conclusion: This MR study validates the potential causal effects of specific dietary intake on different atopic diseases and provides strong support for the development of individualized prevention strategies and health interventions at the family level.