Dermatology Reports最新文献

Psoriasis is recognized not only as a skin disease but also as a systemic disorder. Interleukin-31 (IL-31) may be associated with psoriasis and systemic inflammation. We aimed to quantify serum IL-31 levels in patients with psoriasis and explore their associations with specific clinical manifestations. 30 patients with psoriasis and 30 healthy controls were included in this study. Demographic information and clinical characteristics were obtained through physical examination and medical history review. Serum IL-31 levels were measured using an enzyme-linked immunosorbent assay. IL-31 concentration was significantly higher in patients with psoriasis than in the control group (p<0.001). Patients with psoriasis vulgaris, psoriasis erythroderma, and pustular psoriasis had significantly higher serum IL-31 levels than healthy controls. Additionally, serum IL-31 levels were associated with itch numerical rating scale (NRS) scores and body mass index (BMI) but not with disease severity as measured by the Psoriasis Area and Severity Index (PASI). In patients with psoriasis, increased serum IL-31 levels correlated with itch severity but not with PASI. This suggests that IL-31 may play a critical role in the pathogenesis of psoriasis and could be a valuable target for further studies and therapeutic interventions.

This study analyzed data from hospitals located in three regions of Ethiopia: Addis Ababa, Northeastern Ethiopia, and Southern Ethiopia. The research aims to investigate the prevalence and contributing factors associated with skin diseases in these regions. Skin disorders represent a significant health concern in these areas, though their epidemiology differs markedly from that observed in Western countries. We collected data from 6,449 patients, considering factors like education, income, cultural habits, and access to healthcare. Patients in Southern Ethiopia generally had higher Body mass indexes and incomes and were closer to dermatology centers. The findings indicate that infectious diseases and pruritic dermatoses are the most prevalent skin conditions in all regions. The study highlights the significant impact of socio-economic status on skin health, with higher education correlating with a lower incidence of infectious diseases and sebaceous gland disorders. Overcrowding was associated with a higher occurrence of infectious diseases, emphasizing the importance of hygiene and sanitary conditions. Additionally, the distance from a patient's residence to the hospital influenced the duration of the disease, stressing the need for better accessibility to healthcare services. In conclusion, this research offers important insights into the spectrum of skin diseases in Ethiopia, emphasizing the role of socio-economic factors and the critical need for improved healthcare access and education.

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. BCCs are categorized into "easy-to-treat" and "difficult-to-treat" groups, with the latter including all BCCs that are challenging to manage due to technical, patient-related, or tumor-related factors, such as locally advanced BCCs. In this report, we describe an 84-year-old patient with an extensive, unilateral BCC. Following a decision by the multidisciplinary skin cancer board, the patient was successfully treated with a daily dose of 200 mg of sonidegib, an inhibitor of the Hedgehog pathway, for eight months, acquiring complete clinical and histopathological remission. No significant side effects were reported. The follow-up period of 24 months has shown no negative results.

Cyclin-dependent kinase (CDK) 4/6 inhibitors, such as palbociclib, ribociclib, and abemaciclib, are widely used in combination with endocrine therapy for the treatment of hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer. Despite their efficacy, these drugs are associated with a range of adverse events, including dermatologic toxicities. This case report presents a rare instance of lichenoid dermatitis in a 48-year-old woman following treatment with abemaciclib. The patient developed erythematous, edematous plaques and papules on her hands and forearms, which resolved after discontinuation of the drug and treatment with topical corticosteroids. This report highlights the need for awareness of cutaneous side effects associated with CDK4/6 inhibitors, particularly abemaciclib.

A 71-year-old man presented with a lentigo maligna melanoma (Breslow 0.25 mm) of the left lower eyelid. Complete excision was achieved after 3 Slow Mohs stages, resulting in a quadrangular 1.8x1.2 cm full-thickness defect. After the first stage, upper and lateral margins resulted as histologically infiltrated. Therefore, an additional lateral strip was taken after 3 days, resulting in a tumor-free result. Radicalization was completed after another 8 days on the posterior lamella and rim with immediate reconstruction.

Psoriasis is a chronic immune-mediated disease primarily affecting the skin. The most common subtype is plaque psoriasis, which can affect any body area, with a predilection for the knees, elbows, scalp, lumbosacral region, and genitalia. The European guidelines adopted in Italy recommend systemic therapies for moderate-to-severe psoriasis, defined by a Psoriasis Area and Severity Index (PASI) ≥ 10, Dermatology Life Quality Index (DLQI) ≥ 10, and/or Body Surface Area (BSA) ≥ 10. Over the past two decades, the development of biological agents has revolutionized psoriasis management, targeting specific cytokines such as TNF-α, IL-23, and IL-17. Among these, ixekizumab, secukinumab, brodalumab, and bimekizumab are approved for the treatment of moderate-to-severe plaque psoriasis. However, some patients require switching therapy because of primary/secondary ineffectiveness or side effects. We retrospectively analyzed 20 patients who had switched from one anti-IL-17 drug to another, assessing both safety and effectiveness. 70% of patients was represented by males, with a median age of 49.5 years. The most frequent comorbidities were arterial hypertension and hypercholesterolemia. Effectiveness was evaluated in terms of a 90% (PASI90) and 100% (PASI100) reduction in PASI compared to baseline at 16 and 52 weeks. Before switching to the current IL-17 inhibitor, seven patients had failed at least two biologics. Thirteen patients experienced a loss of effectiveness after more than 6 months (secondary ineffectiveness), whereas the other seven never showed improvement with the previous drug (primary ineffectiveness). Fourteen patients completed at least one year of follow-up. Two patients were lost during the follow-up, while four more are currently still under treatment without having completed the established temporal cut-off. Two patients switched to bimekizumab, nine to brodalumab, and nine to ixekizumab. At baseline, the median PASI was 10 (IQR 4.5). After 16 weeks, the median PASI decreased to 2 (IQR 5.5), and after one year, it was 1 (IQR 2). Eight patients (40%) and six patients (30%) achieved PASI 90 and PASI 100 at 16 weeks, respectively. After one year, sustained effectiveness was observed with PASI 90 (57.1%), PASI 100 (35.7%), and PASI ≤ 2 (78.6%). No serious adverse events or discontinuations due to adverse events were observed during the study period. Our study confirms the safety and effectiveness of intraclass switching among IL-17 antagonists, highlighting that an inter-class switch can be a valid option when patients fail to respond or lose effectiveness with an IL-17 inhibitor. However, further larger and longer studies are needed for a deeper understanding.

Treatment of psoriasis associated with human immunodeficiency virus (HIV) infection is challenging due to the high incidence of comorbidities and polypharmacy and the lack of evidence on the efficacy and safety of available drugs in these patients. Therefore, clinical or anecdotal reports provide useful indications for therapy decision-making. A 64-year male with plaque psoriasis (Psoriasis Area and Severity Index=14.3) infected with HIV for 4 years, with hypercholesterolemia, hypertension, and impaired quality of life (Dermatology Life Quality Index=14) was resistant to topical therapy and acitretin. Tildrakizumab 200 mg was started, obtaining Psoriasis Area and Severity Index=0 at week 16 which was maintained after 13 months of follow-up. No adverse event was reported, and immune cell levels were unchanged. This is the first report on the treatment of psoriasis with tildrakizumab in an HIV+ patient. A literature search showed that prior to this patient, 38 HIV+ subjects had been treated with anti-cytokine agents for psoriasis.

Social media platforms have become integral to healthcare communication, particularly in dermatology, where visual assessment and patient education are paramount. While platforms like Instagram, Facebook, and Twitter offer significant opportunities to raise awareness about skin health, promote preventive measures, and encourage early detection of dermatological conditions, the unregulated dissemination of health information poses substantial risks due to misinformation. In response to these challenges, the Italian Association of Hospital Dermatologists (ADOI) has launched a nationwide survey titled "Use of Social Media by Dermatology Professionals: Impact on Public Awareness, Appropriateness of Information, and Correctness of Prevention Messages-An Italian Survey". This initiative aims to analyze social media usage among dermatology professionals, evaluate its impact on public awareness and preventive behaviors, examine the appropriateness and correctness of shared information, identify challenges and opportunities, and assess the need for official guidelines supported by ADOI. The importance of this study lies in its potential to enhance public health outcomes by ensuring that information shared on social media is accurate, evidence-based, and ethically presented. By collecting data-driven insights, the survey seeks to inform the development of professional guidelines, promote responsible digital engagement, and improve patient education and outcomes. Addressing ethical and privacy concerns is also a key objective. The participation of dermatology professionals is crucial in shaping the future of dermatological care and public health education. This initiative represents a critical step toward improving the quality of dermatological information available on social media and ultimately enhancing patient outcomes through better-informed patients and earlier interventions.

Genital warts (GWs) are the most common sexually transmitted infections worldwide, caused by the human papillomavirus (HPV). In adults, the primary mode of transmission is through sexual contact, whereas in children it can occur through skin-to-skin or skin-to-mucosa contact and be sexual or non-sexual. The increasing prevalence of GWs in children has renewed the interest in therapeutic management which still presents a unique challenge, being influenced by many variables including size, quantity, and location of warts, as well as the presence of comorbidities. Photodynamic therapy (PDT) has already shown encouraging results in treating viral warts in adult patients, but its use is still not standardized in the pediatric population. On this topic, we report the case of an otherwise healthy 5-year-old child affected by GWs, successfully treated with three sessions of PDT with 10% 5-aminolaevulinic acid (ALA), at one-month intervals. Our case is paradigmatic of the potentiality of PDT to treat difficult lesions in a pediatric setting.