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Dupilumab for the Treatment of Severe Atopic Dermatitis in an Immunosuppressed Transplant Patient. 杜匹单抗治疗免疫抑制移植患者的严重特应性皮炎
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-08-10 DOI: 10.1089/derm.2023.0181
Afsoon Ghafari-Saravi, Teri M Greiling
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引用次数: 0
Cinnamic Aldehyde Causing Chronic Oral Mucosal Ulcerations. 肉桂醛导致慢性口腔黏膜溃疡
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-05-23 DOI: 10.1089/derm.2023.0043
Jordan Phillipps, Jeremy G Light, David Sheinbein
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引用次数: 0
Allergic Contact Stomatitis Caused by (Meth)acrylates in a Gingival Protection Product Used During Teeth Whitening. 牙齿美白过程中使用的牙龈保护产品中的(甲基)丙烯酸酯引起的过敏性接触口炎。
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-08-24 DOI: 10.1089/derm.2023.0180
Michitaro Hayakawa, Yuko Baba, Michiyoshi Kouno
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引用次数: 0
Efficacy of Dupilumab in Children 6 Months to 11 Years Old With Atopic Dermatitis: A Retrospective Real-World Study in China. 杜匹单抗对 6 个月至 11 岁特应性皮炎患儿的疗效:中国的一项回顾性真实世界研究。
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-02-17 DOI: 10.1089/derm.2022.0069
Nali Yang, Yahui Ye, Junyi Shao, Hanwen Wu, Qiuyang Xu, Jilin Zhu, Jingjing Liu, Zhiming Li

Background: Atopic dermatitis (AD) is a common skin disease that affects patients' quality of life, especially in the pediatric population. Dupilumab has shown good efficacy and safety in the treatment of AD in adolescents and adults, but the real data on younger children using dupilumab are scarce. Objectives: We investigated the doses, efficacy, and safety of dupilumab in children with moderate-to-severe AD aged ≥6 months to 11 years. Methods: This single-center retrospective cohort analysis included dupilumab-treated patients with severe AD under 12 years of age. Primary endpoints included the proportion of Validated Investigator Global Assessment (vIGA) 0/1 achieved and the percentage change from baseline in eczema area and severity index (EASI) and SCORing Atopic Dermatitis (SCORAD) at week 24 (W24). Secondary endpoints were mean change in pruritus numerical rating score (P-NRS) and body surface area (BSA) after W24 of treatment, description of adverse events, and Children's Dermatology Life Quality Index (CDLQI) improvement from baseline in endpoints. Results: Fifty-seven patients were included (mean age 7.2 ± 3.0 years). The primary endpoint (vIGA = 0/1) was achieved by 51 of 57 (89.5%) patients at W24. Significant improvements in EASI, SCORAD, P-NRS, and CDLQI scores were observed from baseline to W24 with dupilumab treatment and remained until W40. In different age groups, the endpoint vIGA achieved 0/1: 95.2% (20/21) of younger children and 88.9% (32/36) of older children. No serious adverse drug reactions were reported. Conclusions: This study aimed to describe the safety and efficacy of dupilumab in pediatric patients and examined differences of efficacy with various doses. The outcomes are comparable with those of existing clinical trials. Phase III Clinical Trial: NCT03346434.

背景:特应性皮炎(AD)是一种影响患者生活质量的常见皮肤病,尤其是在儿童群体中。杜比鲁单抗在治疗青少年和成人特应性皮炎方面显示出良好的疗效和安全性,但使用杜比鲁单抗治疗年幼儿童的真实数据却很少。我们的目标是我们对年龄≥6 个月至 11 岁的中重度 AD 儿童使用杜比鲁单抗的剂量、疗效和安全性进行了调查。方法:这是一项单中心回顾性队列研究:这项单中心回顾性队列分析包括接受过杜比鲁单抗治疗的 12 岁以下重度 AD 患者。主要终点包括第24周(W24)时达到验证研究者总体评估(vIGA)0/1的比例以及湿疹面积和严重程度指数(EASI)和SCORing特应性皮炎(SCORAD)与基线相比的百分比变化。次要终点是治疗第24周后瘙痒数值评分(P-NRS)和体表面积(BSA)的平均变化、不良事件描述以及儿童皮肤病生活质量指数(CDLQI)与基线相比的终点改善情况。结果:共纳入 57 名患者(平均年龄为 7.2 ± 3.0 岁)。57 名患者中有 51 名(89.5%)在治疗第 24 个月时达到了主要终点(vIGA = 0/1)。从基线到W24,接受dupilumab治疗的患者EASI、SCORAD、P-NRS和CDLQI评分均有显著改善,并一直保持到W40。在不同年龄组中,终点 vIGA 均为 0/1:95.2% 的低龄儿童(20/21)和 88.9%的高龄儿童(32/36)。无严重药物不良反应报告。结论这项研究旨在描述杜比鲁单抗在儿童患者中的安全性和有效性,并考察不同剂量的疗效差异。研究结果与现有临床试验结果相当。III期临床试验:NCT03346434。
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引用次数: 0
A Retrospective Analysis of Risk Factors for Atopic Dermatitis Severity. 特应性皮炎严重程度风险因素的回顾性分析
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-04-26 DOI: 10.1089/derm.2023.0037
Min Luo, Huichun C Su, Jinger E Lin, Changhua H Zhu, Lihang H Lin, Yue Han

Background: Atopic dermatitis (AD) has the highest burden of any skin disease; however, the severity-associated factors remain unclear. Objective: To evaluate potential severity-associated factors of AD and to design and validate a severity prediction model to inform the management of AD patients. Methods: A cross-sectional study of 900 AD patients was conducted from December 2021 to October 2022 at our hospital. The primary outcome was disease severity, categorized as mild, moderate, or severe using the scoring atopic dermatitis index. Ordinal logistic regression and bootstrapped validation were used to derive and internally validate the model. Results: Increasing age, elevated eosinophil level, higher economic status, and urban residence were associated with severe AD. Breastfeeding, disinfectants and topical emollients use, and short duration of bathing were associated with mild AD. In the prediction model, predictors included age, eosinophil and economic status, residence, feeding, disinfectants and emollients use, and duration of bathing. Prediction models demonstrated good discrimination (bias-corrected concordance index [c-index] = 0.72) and good calibration. Conclusion: Risk factors for the severity of AD were identified that could aid the early prediction of AD progression. The predictive model included variables that are easily evaluated and could inform personalized prevention and therapy.

背景:特应性皮炎(AD)是负担最重的皮肤病,但其严重程度的相关因素仍不清楚。目的评估与特应性皮炎严重程度相关的潜在因素,设计并验证严重程度预测模型,为特应性皮炎患者的治疗提供参考。方法:对 900 名 AD 患者进行横断面研究:我院于 2021 年 12 月至 2022 年 10 月对 900 名 AD 患者进行了横断面研究。主要结果是疾病严重程度,使用特应性皮炎评分指数分为轻度、中度和重度。采用序数逻辑回归和引导验证来推导和内部验证模型。结果显示年龄增加、嗜酸性粒细胞水平升高、经济地位较高和居住在城市与严重特应性皮炎有关。母乳喂养、使用消毒剂和局部润肤剂以及洗澡时间短与轻度 AD 相关。在预测模型中,预测因素包括年龄、嗜酸性粒细胞和经济状况、居住地、喂养、使用消毒剂和外用润肤剂以及沐浴时间。预测模型具有良好的区分度(偏差校正一致性指数 [c-index] = 0.72)和校准性。结论研究发现了AD严重程度的风险因素,这些因素有助于早期预测AD的进展。预测模型包括易于评估的变量,可为个性化预防和治疗提供依据。
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引用次数: 0
A Review of Dupilumab-Induced Adverse Events to Dermatologists and the Potential Pathogenesis in the Treatment of Atopic Dermatitis. 回顾杜匹单抗在治疗特应性皮炎过程中给皮肤科医生带来的不良反应以及潜在的发病机制。
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-05-19 DOI: 10.1089/derm.2022.0096
Jun-Hong Tsai, Tsen-Fang Tsai

Dupilumab, a monoclonal antibody targeting interleukin-4 antibody, is approved for use in many type 2 inflammatory diseases, including atopic dermatitis. It is generally well tolerated with no need of routine laboratory monitoring. However, several adverse events have been reported during real-world practice and in pivotal trials. We conducted a systematic literature research of the PubMed, Medline, and Embase databases to identify articles recording the clinical manifestation and potential pathogenesis of these adverse events with interests (AEIs) to dermatologists. In total, 547 cases from 134 studies have developed 39 AEIs 1 day to 2.5 years after dupilumab treatment. The most common AEIs are facial and neck dermatitis (299 cases), psoriasis (70 cases), arthralgia (56 cases), alopecia (21 cases), cutaneous T cell lymphoma (19 cases), severe ocular diseases (19 cases), and drug eruption (6 cases). Most of the AEIs recorded in this review resolved or improved after dupilumab discontinuation or the addition of another treatment, whereas 3 of the cases died of severe AEI. The potential pathogenesis included T help type 1 (Th1)/T help type 2 (Th2) imbalance, Th2/T help type 17 (Th17) imbalance, immune reconstitution, hypersensitivity reaction, transient hypereosinophilia related, and Th1 suppression. Clinicians should be alert of these AEIs for timely diagnosis and appropriate treatment.

杜匹鲁单抗是一种靶向白细胞介素-4抗体的单克隆抗体,已被批准用于包括特应性皮炎在内的多种2型炎症性疾病。该药的耐受性一般良好,无需进行常规实验室监测。然而,在实际应用和关键试验中也有一些不良事件的报道。我们对 PubMed、Medline 和 Embase 数据库进行了系统的文献研究,以找出记录这些不良事件(AEIs)的临床表现和潜在致病机理的文章,供皮肤科医生参考。共有来自 134 项研究的 547 个病例在杜匹单抗治疗后 1 天至 2.5 年内发生了 39 例 AEI。最常见的 AEI 包括面部和颈部皮炎(299 例)、银屑病(70 例)、关节痛(56 例)、脱发(21 例)、皮肤 T 细胞淋巴瘤(19 例)、严重眼部疾病(19 例)和药物疹(6 例)。本综述中记录的大多数 AEI 在停用杜匹单抗或增加另一种治疗方法后缓解或改善,而其中 3 例因严重 AEI 而死亡。潜在的发病机制包括T帮助1型(Th1)/T帮助2型(Th2)失衡、Th2/T帮助17型(Th17)失衡、免疫重建、超敏反应、一过性嗜酸性粒细胞过多相关和Th1抑制。临床医生应警惕这些 AEI,以便及时诊断和采取适当的治疗措施。
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引用次数: 0
Which Clinical Measurement Tools for Atopic Dermatitis Severity Make the Most Sense in Clinical Practice? 哪些特应性皮炎严重程度临床测量工具在临床实践中最有意义?
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-04-11 DOI: 10.1089/derm.2022.0087
Shanthi Narla, Jonathan I Silverberg

Assessment of atopic dermatitis (AD) severity is essential for therapeutic decision making and monitoring treatment progress. However, there are a myriad of clinical measurement tools available, some of which are impractical for routine clinical use despite being recommended for clinical trials in AD. For measurement tools to be used in clinical practice, they should be valid, reliable, rapidly completed, and scored, and easily incorporated into existing clinic workflows. This narrative review addresses content, validity, and feasibility, and provides a simplified repertoire of assessments for clinical assessment of AD based on prior evidence and expert opinion. Tools that may be feasible for clinical practice include patient-reported outcomes (eg, dermatology life quality index, patient-oriented eczema measure, numerical rating scales for itch, pain, and sleep disturbance, AD Control Tool, and patient-reported global assessment), and clinician-reported outcomes (eg, body surface area and investigator's global assessment). AD is associated with variable clinical signs, symptoms, extent of lesions, longitudinal course, comorbidities, and impacts. Any single domain is insufficient to holistically characterize AD severity, select therapy, or monitor treatment response. A combination of these tools is recommended to balance completeness and feasibility.

评估特应性皮炎(AD)的严重程度对于制定治疗决策和监控治疗进展至关重要。然而,现有的临床测量工具种类繁多,其中一些尽管被推荐用于特应性皮炎的临床试验,但却不适合常规临床使用。要想在临床实践中使用测量工具,它们应该有效、可靠、能快速完成和评分,并能轻松融入现有的临床工作流程。这篇叙述性综述论述了这些工具的内容、有效性和可行性,并根据先前的证据和专家意见提供了一套简化的评估工具,用于对AD进行临床评估。可用于临床实践的工具包括患者报告的结果(如皮肤科生活质量指数、以患者为导向的湿疹测量、瘙痒、疼痛和睡眠障碍数字评分量表、AD 控制工具和患者报告的总体评估)和临床医生报告的结果(如体表面积和研究者的总体评估)。注意力缺失症与不同的临床体征、症状、病变范围、纵向病程、合并症和影响有关。任何单一领域都不足以全面描述 AD 的严重程度、选择治疗方法或监测治疗反应。建议结合使用这些工具,以兼顾完整性和可行性。
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引用次数: 0
The Diagnostic Value of Delayed-Type Reactions to Perennial Aeroallergens for Atopic Disease. 对多年生空气过敏原的延迟型反应对特应性疾病的诊断价值。
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-05-03 DOI: 10.1089/derm.2022.0050
Puneet Arora, Rebecca L Freese, Paul L Bigliardi

Background: Delayed-type reactions to aeroallergens have been observed, however, their clinical significance continues to be debated. Objective: We assessed the prevalence and significance of delayed-type reactions to aeroallergens in atopic patients. Methods: Retrospective study including 266 patients with history or evidence of atopic disease (atopic dermatitis [AD], allergic rhinitis, and/or allergic asthma) and tested via either the intradermal skin test (IDT) or atopy patch test for common aeroallergens, specifically house dust mites (Dermatophagoides farinae, Dermatophagoides pteronyssinus) and perennial molds (Aspergillus fumigatus, Penicillium notatum). All patients were tested via IDT with both immediate (15 minute) and delayed (2 and 4 days) readings. Delayed reading was considered positive if the IDT injection site demonstrated at least 5 mm induration 48 hours after inoculation. Results: In total, 195 (73.3%) patients demonstrated an immediate-type reaction, whereas 118 (44.4%) had a delayed-type reaction. In total, 75 (28.2%) patients experienced both immediate- and delayed-type reactions, 43 (16.2%) reacted delayed-type only, and 85.3% of delayed-type reactions to individual aeroallergens were associated with eczematous lesions predominantly in air-exposed areas. Conclusion: Delayed-type reactions to aeroallergens are prevalent and clinically significant as a component of extrinsic AD and atopic diseases. The data support delayed reading of the IDT to guide diagnosis and management in these patients.

背景:已观察到对航空过敏原的延迟型反应,但其临床意义仍存在争议。目的:我们评估了过敏症患者延迟型反应的发生率和意义:我们评估了特应性患者对空气过敏原的延迟型反应的发生率和意义。方法:回顾性研究回顾性研究纳入了 266 名有特应性疾病(特应性皮炎 [AD]、过敏性鼻炎和/或过敏性哮喘)病史或证据的患者,并通过皮内皮肤测试(IDT)或特应性贴片测试对常见的过敏原进行了检测,特别是屋尘螨(Dermatophagoides farinae、Dermatophagoides pteronyssinus)和多年生霉菌(Aspergillus fumigatus、Penicillium notatum)。所有患者都通过 IDT 进行了即时(15 分钟)和延迟(2 天和 4 天)读数检测。如果 IDT 注射部位在接种 48 小时后出现至少 5 毫米的压痕,则延迟读数为阳性。结果共有 195 名患者(73.3%)出现即时型反应,118 名患者(44.4%)出现延迟型反应。总共有 75 名(28.2%)患者同时出现即刻型和延迟型反应,43 名(16.2%)患者仅出现延迟型反应,85.3% 的延迟型反应与个别空气过敏原有关,主要是在暴露于空气的部位出现湿疹病变。结论是作为外源性 AD 和特应性疾病的一个组成部分,对空气致敏原的延迟型反应普遍存在,并具有重要的临床意义。这些数据支持延迟阅读 IDT,以指导这些患者的诊断和治疗。
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引用次数: 0
IgE-Mediated Hypersensitivity Reaction to Carboxymethyl Cellulose in an Injectable Cosmetic Filler. 注射美容填充剂中的羧甲基纤维素引发的 IgE 媒介超敏反应。
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-05-02 DOI: 10.1089/derm.2023.0015
Helena Pires Pereira, Joni Costa Carvalho, Rafael Santiago, Inês Neves, Carlos Loureiro, Ana Todo-Bom
{"title":"IgE-Mediated Hypersensitivity Reaction to Carboxymethyl Cellulose in an Injectable Cosmetic Filler.","authors":"Helena Pires Pereira, Joni Costa Carvalho, Rafael Santiago, Inês Neves, Carlos Loureiro, Ana Todo-Bom","doi":"10.1089/derm.2023.0015","DOIUrl":"10.1089/derm.2023.0015","url":null,"abstract":"","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eosinophilic Dermatitis due to Triptorelin Pamoate in a Patient with Prostate Cancer Confirmed by Patch Testing. 经斑贴试验证实的前列腺癌患者帕莫酸曲普瑞林引起的嗜酸性皮炎
IF 5.2 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-07-11 DOI: 10.1089/derm.2023.0024
Dimitra Koumaki, Stamatios Gregoriou, Leonidas Marinos, Alexander Katoulis, Marios Papadakis, Georgios Evangelou, Konstantinos Krasagakis
{"title":"Eosinophilic Dermatitis due to Triptorelin Pamoate in a Patient with Prostate Cancer Confirmed by Patch Testing.","authors":"Dimitra Koumaki, Stamatios Gregoriou, Leonidas Marinos, Alexander Katoulis, Marios Papadakis, Georgios Evangelou, Konstantinos Krasagakis","doi":"10.1089/derm.2023.0024","DOIUrl":"10.1089/derm.2023.0024","url":null,"abstract":"","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":null,"pages":null},"PeriodicalIF":5.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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