Yusuf Can Edek, Yağmur Aypek, Betül Öğüt, Özlem Erdem, Esra Adışen
Introduction: Acquired perforating dermatosis (APD) is a disease group characterized by transepidermal elimination of dermal connective tissue materials such as collagen, elastic fibers, and keratin through the epidermis and observed with pruritic skin lesions.
Objectives: In this study, we aim to clarify the clinical, histopathological, and dermoscopic characteristics of APD, identify the associated systemic disease, and figure out treatment options.
Methods: This study was designed as a single-center retrospective, observational, cross-sectional study. We evaluated all accessible APD cases between January 2004 and June 2022 in a tertiary care hospital.
Results: A total of 95 patients with confirmed APD were included in the study. Sixty percent of the patients were women and 40% were men. The median age at diagnosis was 63.1 years (35-85 years). The most common site of lesions was the lower extremities which were detected in 86.31% of the patients. The concomitant systemic disease was identified in 84.21% of the patients. The most common systemic disease was type 2 diabetes mellitus (65.26%). Antihistamines and topical corticosteroids were the most commonly prescribed treatment agents.
Conclusions: Transepidermal elimination of dermal connective tissue components is a feature of APD and the disease usually presents with pruritic papules and nodules with central keratotic crust or plug. The diagnosis of APD requires a clinical examination and histological investigation. APD is usually accompanied by systemic comorbidities. There are several topical and systemic medications available for APD, however, sometimes the therapy might be challenging.
{"title":"Acquired Perforating Dermatosis: Clinical and Histopathological Analysis of 95 Patients From One Center.","authors":"Yusuf Can Edek, Yağmur Aypek, Betül Öğüt, Özlem Erdem, Esra Adışen","doi":"10.5826/dpc.1402a100","DOIUrl":"10.5826/dpc.1402a100","url":null,"abstract":"<p><strong>Introduction: </strong>Acquired perforating dermatosis (APD) is a disease group characterized by transepidermal elimination of dermal connective tissue materials such as collagen, elastic fibers, and keratin through the epidermis and observed with pruritic skin lesions.</p><p><strong>Objectives: </strong>In this study, we aim to clarify the clinical, histopathological, and dermoscopic characteristics of APD, identify the associated systemic disease, and figure out treatment options.</p><p><strong>Methods: </strong>This study was designed as a single-center retrospective, observational, cross-sectional study. We evaluated all accessible APD cases between January 2004 and June 2022 in a tertiary care hospital.</p><p><strong>Results: </strong>A total of 95 patients with confirmed APD were included in the study. Sixty percent of the patients were women and 40% were men. The median age at diagnosis was 63.1 years (35-85 years). The most common site of lesions was the lower extremities which were detected in 86.31% of the patients. The concomitant systemic disease was identified in 84.21% of the patients. The most common systemic disease was type 2 diabetes mellitus (65.26%). Antihistamines and topical corticosteroids were the most commonly prescribed treatment agents.</p><p><strong>Conclusions: </strong>Transepidermal elimination of dermal connective tissue components is a feature of APD and the disease usually presents with pruritic papules and nodules with central keratotic crust or plug. The diagnosis of APD requires a clinical examination and histological investigation. APD is usually accompanied by systemic comorbidities. There are several topical and systemic medications available for APD, however, sometimes the therapy might be challenging.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The introduction of Janus Kinase inhibitors (JAKi) seems to revolutionize the field of alopecia areata (AA) therapeutics. However, real-world data are still missing.
Objectives: To provide evidence about effectiveness and safety of tofacitinib and baricitinib in AA in real-world settings and describe baseline disease characteristics and patients profiles that are considered good candidates for JAKi in the daily practice. Furthermore, we intended to investigate potential correlations between baseline characteristics and treatment outcomes.
Methods: We retrospectively reviewed the databases of two tertiary Hospitals in Greece, to identify individuals of any age currently being treated with systemic JAKi for severe AA.
Results: We identified 42 individuals, including 3 adolescents. In our cohort, 52.3% (22/42) were under tofacitinib and 47.6% (20/42) under baricitinib treatment. Efficacy analysis was performed on the subgroup of 30 patients that had completed at least a 3-month follow-up on treatment. In the latter group, mean time on treatment was 10 months. Mean Severity of Alopecia Tool and mean Dermatology Life Quality Index scores decreased from 84.46% and 12.86 at baseline, to 43.26% and 6.63, respectively. Complete response (CR) was recorded in 4 (13.33%), partial in 12 (40%) and no response in 14 patients (46.66%), correspondingly. Seventeen out of 42 (40.5%) individuals in total, reported at least 1 adverse event. No patient required hospitalization. Among 15 patients (35.7%) who got COVID-19, one suffered from serious infection. The 3 adolescents achieved CR with no significant adverse events.
Conclusions: Real-world data suggest efficacy and safety of JAKi in severe forms of AA. Tolerability is optimal in younger individuals.
导言:Janus 激酶抑制剂(JAKi)的问世似乎将彻底改变斑秃(AA)治疗领域。然而,真实世界的数据仍然缺失:目的:提供托法替尼和巴利昔尼在现实世界中治疗斑秃的有效性和安全性的证据,并描述基线疾病特征和在日常实践中被认为是JAKi良好候选者的患者情况。此外,我们还打算研究基线特征与治疗结果之间的潜在相关性:我们回顾性地查看了希腊两家三级医院的数据库,以确定目前正在接受全身性 JAKi 治疗的任何年龄的重症 AA 患者:结果:我们发现了42名患者,其中包括3名青少年。在我们的队列中,52.3%(22/42)的患者接受了托法替尼治疗,47.6%(20/42)的患者接受了巴利昔尼治疗。疗效分析针对至少完成了 3 个月随访的 30 例患者分组进行。后一组患者的平均治疗时间为 10 个月。脱发严重程度工具(Severity of Alopecia Tool)和皮肤科生活质量指数(Dermatology Life Quality Index)的平均得分分别从基线时的84.46%和12.86分降至43.26%和6.63分。4 名患者(13.33%)完全应答,12 名患者(40%)部分应答,14 名患者(46.66%)无应答。42名患者中有17名(40.5%)报告了至少一次不良反应。没有患者需要住院治疗。在接受 COVID-19 治疗的 15 名患者(35.7%)中,有一人出现严重感染。3名青少年达到了CR,且无明显不良反应:真实世界的数据表明,JAKi对重症AA具有疗效和安全性。结论:真实世界的数据表明,JAKi对重症AA具有疗效和安全性,对年轻人的耐受性最佳。
{"title":"Real-World Experience of Tofacitinib and Baricitinib Use in Alopecia Areata in Greek Population: A Retrospective Analysis With Focus on Safety.","authors":"Zoe Apalla, Efterpi Zafiriou, Effimia Zagkliverinou, Angeliki-Viktoria Roussaki-Schulze, Polyxeni Gidarokosta, Niki Ntavari, Stella Sakellaropoulou, Maria Boziou, Anastasia Emvalomati, Eirini Kyrmanidou, Elizabeth Lazaridou","doi":"10.5826/dpc.1402a73","DOIUrl":"10.5826/dpc.1402a73","url":null,"abstract":"<p><strong>Introduction: </strong>The introduction of Janus Kinase inhibitors (JAKi) seems to revolutionize the field of alopecia areata (AA) therapeutics. However, real-world data are still missing.</p><p><strong>Objectives: </strong>To provide evidence about effectiveness and safety of tofacitinib and baricitinib in AA in real-world settings and describe baseline disease characteristics and patients profiles that are considered good candidates for JAKi in the daily practice. Furthermore, we intended to investigate potential correlations between baseline characteristics and treatment outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed the databases of two tertiary Hospitals in Greece, to identify individuals of any age currently being treated with systemic JAKi for severe AA.</p><p><strong>Results: </strong>We identified 42 individuals, including 3 adolescents. In our cohort, 52.3% (22/42) were under tofacitinib and 47.6% (20/42) under baricitinib treatment. Efficacy analysis was performed on the subgroup of 30 patients that had completed at least a 3-month follow-up on treatment. In the latter group, mean time on treatment was 10 months. Mean Severity of Alopecia Tool and mean Dermatology Life Quality Index scores decreased from 84.46% and 12.86 at baseline, to 43.26% and 6.63, respectively. Complete response (CR) was recorded in 4 (13.33%), partial in 12 (40%) and no response in 14 patients (46.66%), correspondingly. Seventeen out of 42 (40.5%) individuals in total, reported at least 1 adverse event. No patient required hospitalization. Among 15 patients (35.7%) who got COVID-19, one suffered from serious infection. The 3 adolescents achieved CR with no significant adverse events.</p><p><strong>Conclusions: </strong>Real-world data suggest efficacy and safety of JAKi in severe forms of AA. Tolerability is optimal in younger individuals.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabella Mark, Michael J Diaz, Jasmine T Tran, Shari R Lipner
{"title":"There Exist Educational Deficiencies in Specialized Dermatologic Care: Implications for Patients of Different Sexes, Genders, and Sexual Orientations.","authors":"Isabella Mark, Michael J Diaz, Jasmine T Tran, Shari R Lipner","doi":"10.5826/dpc.1402a128","DOIUrl":"10.5826/dpc.1402a128","url":null,"abstract":"","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
José Magna Aguirre, Paula Almeida Abarcia, Pablo Vargas Mora
{"title":"Dermoscopic Findings in Skin Infection by Mycobacterium Immunogenum.","authors":"José Magna Aguirre, Paula Almeida Abarcia, Pablo Vargas Mora","doi":"10.5826/dpc.1402a115","DOIUrl":"10.5826/dpc.1402a115","url":null,"abstract":"","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gamze Taş-Aygar, Hatice Ataş, Müzeyyen Gönül, Selda Pelin Kartal
Introduction: The C-reactive protein to albumin ratio (CAR) lately has demonstrated as a prognostic factor and an indicator of disease activity, severity and prognosis in solid organ malignancies and inflammatory diseases. However, the effects of CAR have not been investigated in mycosis fungoides (MF) patients yet.
Objectives: This study aimed to determine the potential role of CAR as a diagnostic and a prognostic indicator in MF.
Methods: We retrospectively investigated the electronic medical records of 97 patients with MF admitted to the Dermatology Clinic of Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital between January 2014 and December 2020. In total, 60 patients with MF were enrolled in the study. CAR was evaluated, patient and control group. Also, the other clinicopathological factors including age, lactate dehydrogenase, stage of disease, beta-2-microglobulin levels, and sedimentation levels were evaluated.
Results: The median value of CAR was 0.85 (0.10-7.51) in the patient group, whereas it was 0.39 (0.0-1.11) in the control group (P < 0.001). Patients with disease progression (N = 16, 13M, 3 F) had a median value of CAR 0.84 (0.10-7.51) and the median value of CAR (N = 44) was 0.86 (0.12-4.57) in the group of patients with stable disease. The CAR value had no prognostic significance (P > 0.05).
Conclusions: There is no association between the CAR and progression in the stage in MF patients. But the CAR is significantly higher in patients with MF than in the control group. The CAR can be a guide for us in cases where we have difficulty in diagnosing.
简介最近,C反应蛋白与白蛋白的比值(CAR)已被证明是实体器官恶性肿瘤和炎症性疾病的预后因素以及疾病活动性、严重程度和预后的指标。然而,CAR对真菌病(MF)患者的影响尚未得到研究:本研究旨在确定 CAR 作为 MF 诊断和预后指标的潜在作用:我们回顾性调查了2014年1月至2020年12月期间在健康科学大学Diskapi Yildirim Beyazit培训与研究医院皮肤科门诊就诊的97名MF患者的电子病历。共有 60 名手足口病患者参与研究。对患者组和对照组进行了 CAR 评估。此外,还评估了其他临床病理因素,包括年龄、乳酸脱氢酶、疾病分期、β-2-微球蛋白水平和血沉水平:患者组 CAR 的中位值为 0.85(0.10-7.51),而对照组为 0.39(0.0-1.11)(P < 0.001)。疾病进展患者(N = 16,13 名男性,3 名女性)的 CAR 中位值为 0.84(0.10-7.51),疾病稳定患者组的 CAR 中位值(N = 44)为 0.86(0.12-4.57)。CAR值对预后没有意义(P > 0.05):结论:CAR值与MF患者的分期进展之间没有关联。结论:骨髓纤维瘤患者的 CAR 值与分期进展没有关联,但骨髓纤维瘤患者的 CAR 值明显高于对照组。在我们诊断有困难的病例中,CAR 可以为我们提供指导。
{"title":"Importance of the C-Reactive Protein to Albumin Ratio in the Diagnosis and Prognosis of Mycosis Fungoides.","authors":"Gamze Taş-Aygar, Hatice Ataş, Müzeyyen Gönül, Selda Pelin Kartal","doi":"10.5826/dpc.1402a97","DOIUrl":"10.5826/dpc.1402a97","url":null,"abstract":"<p><strong>Introduction: </strong>The C-reactive protein to albumin ratio (CAR) lately has demonstrated as a prognostic factor and an indicator of disease activity, severity and prognosis in solid organ malignancies and inflammatory diseases. However, the effects of CAR have not been investigated in mycosis fungoides (MF) patients yet.</p><p><strong>Objectives: </strong>This study aimed to determine the potential role of CAR as a diagnostic and a prognostic indicator in MF.</p><p><strong>Methods: </strong>We retrospectively investigated the electronic medical records of 97 patients with MF admitted to the Dermatology Clinic of Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital between January 2014 and December 2020. In total, 60 patients with MF were enrolled in the study. CAR was evaluated, patient and control group. Also, the other clinicopathological factors including age, lactate dehydrogenase, stage of disease, beta-2-microglobulin levels, and sedimentation levels were evaluated.</p><p><strong>Results: </strong>The median value of CAR was 0.85 (0.10-7.51) in the patient group, whereas it was 0.39 (0.0-1.11) in the control group (P < 0.001). Patients with disease progression (N = 16, 13M, 3 F) had a median value of CAR 0.84 (0.10-7.51) and the median value of CAR (N = 44) was 0.86 (0.12-4.57) in the group of patients with stable disease. The CAR value had no prognostic significance (P > 0.05).</p><p><strong>Conclusions: </strong>There is no association between the CAR and progression in the stage in MF patients. But the CAR is significantly higher in patients with MF than in the control group. The CAR can be a guide for us in cases where we have difficulty in diagnosing.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ibrahim Fouda, Hassan Abou Khodair Mohammed, Ghada Mohammed Yousef Mohammed
Introduction: Warts are the most prevalent clinical manifestation of Human Papilloma Virus (HPV) infections, which vary in morphological pattern depending on the site of the body affected.
Objectives: To evaluate the safety and efficacy of intralesional quadrivalent HPV vaccine versus candida antigen in treatment of multiple recalcitrant non-genital warts.
Methods: A randomized-control clinical trial included 60 cases with multiple recalcitrant warts who were randomly distributed into three groups; Group I included 20 patients who received intralesional candida antigen at a dose of 0.3 mL of 1/1000 solution, Group II included 20 patients who received intralesional quadrivalent HPV vaccine at a dose of 0.3ml and Group III included 20 patients who received intralesional injection 0.3 ml of normal saline 0.9% as a control group). Each agent was injected at the base of the largest wart every three weeks until it was completely cleared, or for a total of four sessions.
Results: the highest response rate was detected in the quadrivalent HPV vaccine group (75% complete response) followed by the candida vaccine group (40% complete response and 15% partial response). Also, regarding the distant response rate, the highest response rate was detected in the quadrivalent HPV vaccine group (72.7% complete response and 27.3% partial response) followed by the candida vaccine group (33.3% complete response and 50% partial response).
Conclusions: Intralesional immunotherapy appears to be effective and safe in treating multiple recalcitrant non-genital warts, with intralesional quadrivalent HPV vaccine outperforming intralesional candida antigen.
{"title":"Intralesional Quadrivalent Human Papilloma Virus Vaccine Versus Candida Antigen in the Treatment of Multiple Recalcitrant Non-Genital Warts.","authors":"Ibrahim Fouda, Hassan Abou Khodair Mohammed, Ghada Mohammed Yousef Mohammed","doi":"10.5826/dpc.1402a66","DOIUrl":"10.5826/dpc.1402a66","url":null,"abstract":"<p><strong>Introduction: </strong>Warts are the most prevalent clinical manifestation of Human Papilloma Virus (HPV) infections, which vary in morphological pattern depending on the site of the body affected.</p><p><strong>Objectives: </strong>To evaluate the safety and efficacy of intralesional quadrivalent HPV vaccine versus candida antigen in treatment of multiple recalcitrant non-genital warts.</p><p><strong>Methods: </strong>A randomized-control clinical trial included 60 cases with multiple recalcitrant warts who were randomly distributed into three groups; Group I included 20 patients who received intralesional candida antigen at a dose of 0.3 mL of 1/1000 solution, Group II included 20 patients who received intralesional quadrivalent HPV vaccine at a dose of 0.3ml and Group III included 20 patients who received intralesional injection 0.3 ml of normal saline 0.9% as a control group). Each agent was injected at the base of the largest wart every three weeks until it was completely cleared, or for a total of four sessions.</p><p><strong>Results: </strong>the highest response rate was detected in the quadrivalent HPV vaccine group (75% complete response) followed by the candida vaccine group (40% complete response and 15% partial response). Also, regarding the distant response rate, the highest response rate was detected in the quadrivalent HPV vaccine group (72.7% complete response and 27.3% partial response) followed by the candida vaccine group (33.3% complete response and 50% partial response).</p><p><strong>Conclusions: </strong>Intralesional immunotherapy appears to be effective and safe in treating multiple recalcitrant non-genital warts, with intralesional quadrivalent HPV vaccine outperforming intralesional candida antigen.</p>","PeriodicalId":11168,"journal":{"name":"Dermatology practical & conceptual","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}