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The Global Hidradenitis Suppurativa Atlas Methodology: Combining Global Proportions in a Pooled Analysis. 全球湿疹地图集(GHiSA)方法:汇总分析中的全球比例。
IF 3.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2024-02-14 DOI: 10.1159/000536389
Dorra Bouazzi, Rune K Andersen, Gabrielle R Vinding, Cecilia E Medianfar, Sabrina M Nielsen, Ditte M L Saunte, Nisha S Chandran, Hessel H van der Zee, Christos C Zouboulis, Farida Benhadou, Bente Villumsen, Afsaneh Alavi, Perpetua U Ibekwe, Iltefat H Hamzavi, John R Ingram, Haley B Naik, Amit Garg, Jurr Boer, Robin Christensen, Gregor B E Jemec

Introduction: Data concerning the global burden of hidradenitis suppurativa (HS) are limited. Reported prevalence estimates vary between 0.0003% and 4.1%, and data from various geographical regions are still to be collected. Previously reported prevalences have been limited by the methodological approach and source of data. This has resulted in great heterogeneity as prevalence data from physician-diagnosed cases poorly match those of self-reported apparent HS disease.

Methods: The Global Hidradenitis Suppurativa Atlas (GHiSA) introduces an innovative approach to determine the global prevalence of HS. This approach involves using a previously validated questionnaire to screen apparently healthy adults accompanying a patient to a non-dermatological outpatient clinic visit in a hospital or a private/family medicine clinic. The screening questionnaire (i.e., the index test) is combined with a subsequent physician-based in-person validation (i.e., the reference standard) of the participants who screen positive. Approximately ten percent of the screen-negative participants are also clinically assessed to verify the diagnostic precision of the test. The local prevalence (pi) will be estimated from each country that submits the number of patients who are HS positive according to the index test and clinical examination (n), and the corresponding total number of observations (N).

Conclusion: The GHiSA Global Prevalence studies are currently running simultaneously in 58 countries across six continents (Africa, Europe, Australia, North America, South America, and Asia). The goal of the combined global proportion is the generation of a single summary (i.e., proportional meta-analysis), which will be done after a logit transformation and synthesized using a random-effects model. The novel standardization of the Global Prevalence Studies conducted through GHiSA enables direct international comparisons, which were previously not possible due to substantial heterogeneity in past HS prevalence studies.

导言:有关化脓性扁桃体炎(HS)全球负担的数据十分有限。已报告的发病率估计值在 0.0003% 到 4.1% 之间,各地理区域的数据仍有待收集。以前报告的患病率受到方法和数据来源的限制。由于医生诊断病例的患病率数据与自我报告的明显HS疾病的患病率数据相差甚远,因此造成了很大的异质性:全球湿疹地图集》(GHiSA)采用了一种创新方法来确定湿疹的全球患病率。该方法包括使用一份事先经过验证的调查问卷,对陪同患者到医院非皮肤科门诊就诊的表面上健康的成年人进行筛查。筛查问卷(即指标检测)与随后对筛查结果呈阳性的参与者进行的医生亲自验证(即参考标准)相结合。此外,还对 10% 筛查阴性的参与者进行临床评估,以验证检测的诊断精确度。每个国家根据指标检测和临床检查提交的 HS 阳性患者人数(n)和相应的观察总数(N)将估算出当地的流行率(pi):GHiSA 全球流行率研究目前在六大洲(非洲、欧洲、澳大利亚、北美洲、南美洲和亚洲)的 58 个国家同时进行。合并全球比例的目标是生成一个单一的摘要(即比例荟萃分析),该摘要将在对数转换后完成,并使用随机效应模型进行综合分析。通过 GHiSA 对全球流行率研究进行新颖的标准化,可以进行直接的国际比较,而在过去,由于 HS 流行率研究中存在大量的异质性,因此无法进行直接的国际比较。
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引用次数: 0
Challenges in Psoriasis Research: A Systematic Review of Preclinical Models. 牛皮癣研究面临的挑战:临床前模型的系统回顾。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2024-06-10 DOI: 10.1159/000538993
Ana Ubago-Rodríguez, María I Quiñones-Vico, Manuel Sánchez-Díaz, Raquel Sanabria-de la Torre, Álvaro Sierra-Sánchez, Trinidad Montero-Vílchez, Ana Fernández-González, Salvador Arias-Santiago

Introduction: Psoriasis is a chronic inflammatory skin disease with variable clinical presentation, multifactorial etiology and an immunogenetic basis. Several studies demonstrate that it results from a dysregulated interaction between skin keratinocytes, immune cells, and the environment that leads to a persistent inflammatory process modulated by cytokines and T cells. The development of new treatment options requires increased understanding of pathogenesis. However, the successful implementation of effective drugs requires well-characterized and highly available preclinical models that allow researchers to quickly and reproducibly determine their safety and efficacy.

Methods: A systematic search on PubMed and Scopus databases was performed and assessed to find appropriate articles about psoriasis models applying the key words previously defined. The PRISMA guidelines were employed.

Results: A total of 45 original articles were selected that met the selection criteria. Among these, there are articles on in vivo, in vitro, and ex vivo models, with the in vitro model being the majority due to its ease of use. Within animal models, the most widely used in recent years are chemically induced models using a compound known as imiquimod. However, the rest of the animal models used throughout the disease's research were also discussed. On the other hand, in vitro models were divided into two and three dimensions. The latter were the most used due to their similarity to human skin. Lastly, the ex vivo models were discussed, although they were the least used due to their difficulty in obtaining them.

Conclusions: Therefore, this review summarizes the current preclinical models (in vivo, in vitro, and ex vivo), discussing how to develop them, their advantages, limitations, and applications. There are many challenges to improve the development of the different models. However, research in these in vitro model studies could reduce the use of animals. This is favored with the use of future technologies such as 3D bioprinting or organ-on-a-chip technologies.

简介银屑病是一种慢性炎症性皮肤病,临床表现各异,具有多因素病因和免疫遗传基础。多项研究表明,银屑病是皮肤角质细胞、免疫细胞和环境之间相互作用失调的结果,导致细胞因子和 T 细胞调节的持续炎症过程。然而,要成功实施有效的药物,就必须要有特性良好、可用性高的临床前模型,使研究人员能够快速、可重复地确定药物的安全性和有效性:方法:在 PubMed 和 Scopus 数据库中进行了系统搜索,并对搜索结果进行了评估,以根据之前定义的关键词找到有关银屑病模型的适当文章。结果:共筛选出 45 篇原创文章:共筛选出 45 篇符合筛选标准的原创文章。在这些文章中,有关于体内、体外和体外模型的文章,其中体外模型因其易于使用而占大多数。在动物模型中,近年来使用最广泛的是使用一种名为咪喹莫特的化合物的化学诱导模型。不过,我们也讨论了在整个疾病研究中使用的其他动物模型。另一方面,体外模型分为二维和三维模型。三维模型由于与人体皮肤相似而使用最多。最后,还讨论了体外模型,尽管由于难以获得而使用最少:因此,本综述总结了目前的临床前模型(体内、体外和体外),讨论了如何开发这些模型、它们的优势、局限性和应用。要改进不同模型的开发,还面临许多挑战。不过,这些体外模型研究可以减少动物的使用。未来三维生物打印或芯片器官技术的应用将有助于实现这一目标。
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引用次数: 0
Associations of Atopic Dermatitis with Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. 特应性皮炎与注意力缺陷/多动障碍和自闭症谱系障碍的相关性:一项系统综述和荟萃分析。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2023-11-08 DOI: 10.1159/000533366
Yu Cheng, Jing-Wun Lu, Jen-Hung Wang, Ching-Hui Loh, Tai-Li Chen

Background: Atopic dermatitis (AD) shares similarities with attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) regarding pathogenesis involving neuroinflammation and genetics. Nevertheless, evidence on the associations of AD with ADHD and/or ASD is inconclusive. This study aimed to systematically examine the existing evidence on the associations between AD, ADHD, and ASD.

Methods: The Meta-Analysis of Observational Studies in Epidemiology guideline was followed. We searched MEDLINE, Embase, Cochrane Library, and Web of Science databases from their respective inceptions to March 4, 2022. Observational studies providing adjusted estimates and/or prevalences for ADHD and ASD in patients with AD were enrolled. A random-effects model meta-analysis was conducted to calculate pooled odds ratios (ORs) and confidence intervals (CIs). Subgroup analyses according to AD severity, age, geographic location, and study design were performed.

Results: Overall, a total of 24 studies with 71,373,639 subjects were enrolled. Our meta-analysis demonstrated significant associations of AD with ADHD (pooled OR: 1.28; 95% CI: 1.18-1.40) and ASD (pooled OR: 1.87; 95% CI: 1.30-2.68). Subgroup analyses revealed that the associations for ADHD were the most prominent in studies evaluating severe AD patients as well as in studies focusing on school-age children and adolescents. Among patients with AD, the pooled prevalence of ADHD was 6.6%, and the respective prevalence of ASD was 1.6%.

Conclusion: The evidence to date suggests significant associations of AD with ADHD and ASD. Psychiatric consultation and an interdisciplinary approach would benefit patients with AD presented with behavioral symptoms suggestive of ADHD or ASD.

背景:特应性皮炎(AD)与注意力缺陷/多动障碍(ADHD)和自闭症谱系障碍(ASD)在炎症和遗传学发病机制方面有相似之处。然而,关于AD与ADHD和/或ASD之间关系的证据还没有定论。本研究旨在系统地研究AD、ADHD和ASD之间关系的现有证据。方法:遵循流行病学观察研究的Meta分析指南。我们搜索了MEDLINE、Embase、Cochrane图书馆和Web of Science数据库,从它们各自的概念到2022年2月4日。纳入了提供AD患者ADHD和ASD的调整估计值和/或患病率的观察性研究。进行随机效应模型荟萃分析,以计算合并优势比(OR)和置信区间(CI)。根据AD的严重程度、年龄、地理位置和研究设计进行亚组分析。结果:总体而言,共有24项研究,71373639名受试者入选。我们的荟萃分析显示,AD与ADHD(合并OR为1.28;95%CI为1.18-1.40)和ASD(合并OR,1.87;95%CI,1.30-2.68)之间存在显著关联。亚组分析显示,在评估严重AD患者的研究以及关注学龄儿童和青少年的研究中,ADHD的关联最为突出。在AD患者中,ADHD的合并患病率为6.6%,ASD的患病率分别为1.6%。结论:迄今为止的证据表明,AD与ADHD和ASD有显著关联。精神病咨询和跨学科的方法将有利于AD患者出现提示ADHD或ASD的行为症状。
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引用次数: 0
Topical Corticosteroid Phobia among Danish Pharmacy Staff. 丹麦药房员工的局部皮质类固醇恐惧症。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2024-04-26 DOI: 10.1159/000534766
Jakob Maarbjerg Toft-Hansen, Line Brok Nørreslet, Ida Vittrup, Jacob Pontoppidan Thyssen, Tove Agner, Yasemin Topal Yüksel

Introduction: Topical corticosteroid (TCS) phobia may negatively impact treatment adherence. Currently, there are few studies exploring trust and knowledge of TCS use among pharmacy staff. The objective of this work was to examine TCS knowledge and possible phobia among Danish pharmacy staff.

Methods: A questionnaire, based on Topical Corticosteroid Phobia (TOPICOP©) questionnaire, was developed and rephrased to fit pharmacy staff. The questions were Likert scales and numerical rating scales (NRS) (0-10). In October/November 2021, 64 pharmacies were invited. If the pharmacies agreed to participate, a researcher visited the pharmacies and distributed the questionnaires.

Results: A total of 244 pharmacy workers from 59 pharmacies participated. The majority (95.4%) responded that they were aware of side effects of TCS; however, misconceptions regarding side effects were found in up to 34% of participants. Regarding TCS use, 40% sometimes advised the patients to wait as long as possible before initiating treatment with TCS. Confidence in dispensing TCS to patients was high, with a mean of 8.45 (NRS).

Conclusion: Danish pharmacy staff generally reported high confidence in TCS use. Misconceptions regarding side effects were common, and there was a tendency to giving advices on TCS treatment that may indicate low confidence in TCS. Thorough education of pharmacy staff is needed to improve the knowledge of TCS.

背景:局部皮质类固醇(TCS)恐惧症可能会对坚持治疗产生负面影响。目前,很少有研究探讨药房员工对使用外用皮质类固醇的信任和知识:研究丹麦药房员工对 TCS 的了解程度以及可能存在的恐惧症:方法:根据局部皮质类固醇恐惧症(TOPICOP©)问卷编制了一份问卷,并根据药房员工的情况进行了改写。问题采用李克特量表和数字评定量表(NRS)(0-10)。2021 年 10 月/11 月,64 家药房收到了邀请。如果药店同意参与,研究人员将走访药店并分发问卷:共有来自 59 家药店的 244 名药剂师参与了调查。大多数人(95.4%)回答说他们知道三氯杀螨醇的副作用,但也有高达 34% 的参与者对副作用存在误解。关于 TCS 的使用,40% 的药剂师有时会建议患者在开始使用 TCS 治疗前尽可能等待更长的时间。向患者配发 TCS 的信心很高,平均值为 8.45(NRS):结论:丹麦药剂师普遍对使用 TCS 有很高的信心。结论:丹麦药剂师普遍表示对使用 TCS 有较高的信心,但对副作用的误解很常见,而且倾向于就 TCS 治疗提供建议,这可能表明他们对 TCS 的信心不足。需要对药房工作人员进行全面教育,以提高他们对 TCS 的认识。
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引用次数: 0
Predictors of Recurrence and Progression in Poorly Differentiated Cutaneous Squamous Cell Carcinomas: Insights from a Real-Life Experience. 低分化皮肤鳞状细胞癌复发和进展的预测因素:来自现实生活经验的见解。
IF 3.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2023-11-26 DOI: 10.1159/000535040
Gabriele Roccuzzo, Giulia Orlando, Maria Rebecca Rumore, Antonio Morrone, Enrico Fruttero, Virginia Caliendo, Franco Picciotto, Alberto Sciarrillo, Pietro Quaglino, Paola Cassoni, Simone Ribero, Rebecca Senetta

Introduction: Surgery represents the primary treatment option for cutaneous squamous cell carcinoma (cSCC) aiming for complete tumor resection (R0). Recurrence and metastasis significantly affect survival and outcomes, and poorly differentiated (G3) cSCC is associated with a higher risk of recurrence. However, the specific clinical and histopathological features that predict recurrence and progression in G3-cSCC remain unclear.

Methods: A retrospective analysis was conducted on a series of patients with primary G3-cSCC diagnosed at the Turin University Hospital between January 2016 and January 2021. After independent histological revision, logistic regression models were used to identify clinico-pathological predictors of cutaneous recurrence, lymphnode/metastatic progression, and both types of progression.

Results: Among the 161 G3-cSCC patients, 80.1% (129/161) showed no signs of local recurrence or metastatic progression, while 19.9% (32 patients) had progressed. In the univariate logistic regression, tumor clinical diameter, depth of infiltration (DOI), and lymphovascular invasion (LVI) were identified as significant predictors across the various types of progression (p < 0.05). In the context of multivariate logistic regression, distinct models proved to be significant. For skin recurrence, a 3-variable model incorporating DOI (OR 1.16, 95% CI, 1.01-1.35, p = 0.050), LVI (OR 3.61, 95% CI, 1.11-11.8, p = 0.034), and desmoplasia (OR 3.45, 95% CI, 1.25-9.5, p = 0.017) was selected. Regarding lymphnode/metastatic progression, a 3-variable model combining pT2 (OR 6.10, 95% CI, 1.15-32.35, p = 0.034), pT3 (OR 14.33, 95% CI, 2.79-73.63, p = 0.001), and LVI (OR 3.86, 95% CI, 1.10-13.62, p = 0.036) was identified. Lastly, a 2-variable model for both types of progression consisted of vertical tumor thickness (OR 5.45, 95% CI, 1.11-27.32, p = 0.039) and LVI (OR 1.15, 95% CI, 1.04-1.26, p = 0.006).

Conclusion: Tumor size, DOI, and LVI were significant predictors of recurrence and metastatic progression. Notably, the size of histologically defined tumor-free margins did not affect the risk of recurrence, whilst LVI emerged as a key predictor of all forms of progression. These findings provide insights into risk stratification and suggest that close monitoring and potential adjuvant therapies, such as radiation therapy, may be necessary especially for patients with lymphovascular involvement.

手术是皮肤鳞状细胞癌(cSCC)的主要治疗选择,旨在完全切除肿瘤(R0)。复发和转移显著影响生存和预后,低分化(G3) cSCC与较高的复发风险相关。然而,预测G3-cSCC复发和进展的具体临床和组织病理学特征仍不清楚。方法回顾性分析2016年1月至2021年1月在都灵大学医院诊断的一系列原发性G3-cSCC患者。在独立的组织学修订后,使用逻辑回归模型来确定皮肤复发,淋巴结/转移进展以及两种类型进展的临床病理预测因子。结果161例G3-cSCC患者中,80.1%(129/161)未出现局部复发或转移进展迹象,19.9%(32例)出现进展。在单变量logistic回归中,肿瘤临床直径、浸润深度(DOI)和淋巴血管侵袭(LVI)被确定为各种类型进展的重要预测因素(p . 422)
{"title":"Predictors of Recurrence and Progression in Poorly Differentiated Cutaneous Squamous Cell Carcinomas: Insights from a Real-Life Experience.","authors":"Gabriele Roccuzzo, Giulia Orlando, Maria Rebecca Rumore, Antonio Morrone, Enrico Fruttero, Virginia Caliendo, Franco Picciotto, Alberto Sciarrillo, Pietro Quaglino, Paola Cassoni, Simone Ribero, Rebecca Senetta","doi":"10.1159/000535040","DOIUrl":"10.1159/000535040","url":null,"abstract":"<p><strong>Introduction: </strong>Surgery represents the primary treatment option for cutaneous squamous cell carcinoma (cSCC) aiming for complete tumor resection (R0). Recurrence and metastasis significantly affect survival and outcomes, and poorly differentiated (G3) cSCC is associated with a higher risk of recurrence. However, the specific clinical and histopathological features that predict recurrence and progression in G3-cSCC remain unclear.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on a series of patients with primary G3-cSCC diagnosed at the Turin University Hospital between January 2016 and January 2021. After independent histological revision, logistic regression models were used to identify clinico-pathological predictors of cutaneous recurrence, lymphnode/metastatic progression, and both types of progression.</p><p><strong>Results: </strong>Among the 161 G3-cSCC patients, 80.1% (129/161) showed no signs of local recurrence or metastatic progression, while 19.9% (32 patients) had progressed. In the univariate logistic regression, tumor clinical diameter, depth of infiltration (DOI), and lymphovascular invasion (LVI) were identified as significant predictors across the various types of progression (p &lt; 0.05). In the context of multivariate logistic regression, distinct models proved to be significant. For skin recurrence, a 3-variable model incorporating DOI (OR 1.16, 95% CI, 1.01-1.35, p = 0.050), LVI (OR 3.61, 95% CI, 1.11-11.8, p = 0.034), and desmoplasia (OR 3.45, 95% CI, 1.25-9.5, p = 0.017) was selected. Regarding lymphnode/metastatic progression, a 3-variable model combining pT2 (OR 6.10, 95% CI, 1.15-32.35, p = 0.034), pT3 (OR 14.33, 95% CI, 2.79-73.63, p = 0.001), and LVI (OR 3.86, 95% CI, 1.10-13.62, p = 0.036) was identified. Lastly, a 2-variable model for both types of progression consisted of vertical tumor thickness (OR 5.45, 95% CI, 1.11-27.32, p = 0.039) and LVI (OR 1.15, 95% CI, 1.04-1.26, p = 0.006).</p><p><strong>Conclusion: </strong>Tumor size, DOI, and LVI were significant predictors of recurrence and metastatic progression. Notably, the size of histologically defined tumor-free margins did not affect the risk of recurrence, whilst LVI emerged as a key predictor of all forms of progression. These findings provide insights into risk stratification and suggest that close monitoring and potential adjuvant therapies, such as radiation therapy, may be necessary especially for patients with lymphovascular involvement.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"329-336"},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440447","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
Cutaneous Reactions in Pediatric Patients Treated with MEK Inhibitors: A Retrospective Single-Center Study. 接受MEK抑制剂治疗的儿童患者的皮肤反应--一项回顾性单中心研究。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2024-05-22 DOI: 10.1159/000539374
Rivka Friedland, Mirit Glick, Iris Amitay-Laish, Helen Toledano

Introduction: Mitogen-activated extracellular signal-regulated kinase (MEK) inhibitors are in use for several indications for adults and children. Cutaneous toxicities are among the most common adverse effects. We aimed to describe the spectrum of cutaneous adverse events, its frequency, and severity in a cohort of pediatric patients.

Methods: We reviewed all records of patients in our tertiary treatment center treated with MEK inhibitors between January 2016 and January 2023 for all indications.

Results: Among 33 patients, 76% reported cutaneous adverse effects. The highest prevalence was in the group of patients treated with trametinib (90%), followed by the group treated with selumetinib (50%) and the group treated with a combination of trametinib and B-Raf proto-oncogene serine/threonine-protein kinase inhibitor (dabrafenib, 34%). Xerosis, dermatitis, paronychia, and hair heterochromia were most frequently reported. Severity was graded 1 or 2 for most adverse events, and 237 visits to the dermatology clinic related to these adverse events were recorded.

Conclusions: Cutaneous adverse events are common in the pediatric population as in adults, but the clinical spectrum is different. Although considered mild, multiple dermatological consultations reflect the distress caused by these events. Dermatologists have a central role in the multidisciplinary care of pediatric patients receiving these agents.

导言 MEK 抑制剂可用于成人和儿童的多种适应症。皮肤毒性是最常见的不良反应之一。我们旨在描述一组儿童患者皮肤不良反应的范围、频率和严重程度。方法 我们回顾了 2016 年 1 月至 2023 年 1 月期间在我们的三级治疗中心接受 MEK 抑制剂治疗的所有适应症患者的所有记录。结果 在33名患者中,76%报告了皮肤不良反应。接受曲美替尼治疗的患者发病率最高(90%),其次是接受赛鲁米替尼治疗的患者(50%),以及接受曲美替尼和BRAF抑制剂联合治疗的患者(达拉菲尼,34%)。报告最常见的症状是干癣、皮炎、癣痒和毛发异色。大多数不良事件的严重程度为 1 级或 2 级,有 237 人次因这些不良事件前往皮肤科门诊就诊。结论 皮肤不良反应在儿科人群中与成人一样常见,但临床表现有所不同。虽然这些不良反应被认为是轻微的,但多次皮肤科就诊反映了这些不良反应造成的困扰。皮肤科医生在接受这些药物治疗的儿科患者的多学科护理中发挥着核心作用。
{"title":"Cutaneous Reactions in Pediatric Patients Treated with MEK Inhibitors: A Retrospective Single-Center Study.","authors":"Rivka Friedland, Mirit Glick, Iris Amitay-Laish, Helen Toledano","doi":"10.1159/000539374","DOIUrl":"10.1159/000539374","url":null,"abstract":"<p><strong>Introduction: </strong>Mitogen-activated extracellular signal-regulated kinase (MEK) inhibitors are in use for several indications for adults and children. Cutaneous toxicities are among the most common adverse effects. We aimed to describe the spectrum of cutaneous adverse events, its frequency, and severity in a cohort of pediatric patients.</p><p><strong>Methods: </strong>We reviewed all records of patients in our tertiary treatment center treated with MEK inhibitors between January 2016 and January 2023 for all indications.</p><p><strong>Results: </strong>Among 33 patients, 76% reported cutaneous adverse effects. The highest prevalence was in the group of patients treated with trametinib (90%), followed by the group treated with selumetinib (50%) and the group treated with a combination of trametinib and B-Raf proto-oncogene serine/threonine-protein kinase inhibitor (dabrafenib, 34%). Xerosis, dermatitis, paronychia, and hair heterochromia were most frequently reported. Severity was graded 1 or 2 for most adverse events, and 237 visits to the dermatology clinic related to these adverse events were recorded.</p><p><strong>Conclusions: </strong>Cutaneous adverse events are common in the pediatric population as in adults, but the clinical spectrum is different. Although considered mild, multiple dermatological consultations reflect the distress caused by these events. Dermatologists have a central role in the multidisciplinary care of pediatric patients receiving these agents.</p>","PeriodicalId":11185,"journal":{"name":"Dermatology","volume":" ","pages":"565-571"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11309057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Etanercept versus Methotrexate in the Treatment of Psoriasis and Associated Metabolic Syndrome: 12-Month Open-Label Comparative Study. 依那西普与甲氨蝶呤治疗银屑病及相关代谢综合征:12 个月开放标签比较研究。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2024-07-29 DOI: 10.1159/000540589
Samer A Dhaher, Jinan Q Mohammed

Introduction: Psoriasis is a chronic inflammatory systemic disease accompanied by systemic damage that leads to the development of multiple comorbidities including metabolic syndrome. Conventional systemic therapies for psoriasis are associated with toxicity and have a greater burden on the patients. The study aimed to assess the effectiveness of etanercept (ETN) monotherapy in comparison with methotrexate (MTX) monotherapy.

Methods: In this prospective interventional comparative open-label study, 117 patients with psoriasis were randomized to 2 groups; 1 group of 42 patients; 32 (67.2%) males and 10 (23.8%) females treated with MTX, and the second group of 75 patients; 54 (72%) males and 21 (28%) females treated with ETN. Full laboratory investigations, body mass index (BMI), measurement of skin disease severity which was performed using Psoriasis Area Severity Index (PASI), and the reduction of 75% of the skin lesions (PASI 75) were calculated for all participants.

Results: In the MTX group, there were no significant differences in BMI, or blood pressure after 12 weeks of the study. There is a reduction in the values of FBS, TSC, LDL, TRIG, ESR, CRP, and PASI, but this reduction was statistically not significant. Ten (23.8%) patients achieved PASI 75. In the ETN group, except for BMI, systolic and diastolic blood pressure, all other metabolic syndrome components, inflammatory markers, and PASI were decreased; the reduction was statistically significant. Sixty (80%) patients achieved PASI 75.

Conclusion: Etanercept monotherapy showed greater efficacy than MTX monotherapy in the treatment of moderate to severe plaque-type psoriasis as it achieved greater reductions in PASI score and greater achievement of PASI 75 after 12 weeks. Etanercept monotherapy showed greater efficacy than MTX monotherapy in the improvement of all components of the associated metabolic syndrome except for BMI, which was increased in etanercept-treated patients.

背景:银屑病是一种慢性炎症性全身性疾病,伴有全身性损害,导致包括代谢综合征在内的多种并发症的发生。银屑病的传统系统疗法与毒性相关,给患者带来更大负担。该研究旨在评估依那西普(ETN)单一疗法与甲氨蝶呤(MTX)单一疗法的有效性:在这项前瞻性介入对比开放标签研究中,117名银屑病患者被随机分为两组:一组42人,其中32人(67.2%)为男性,10人(23.8%)为女性,接受MTX治疗;另一组75人,其中54人(72%)为男性,21人(28%)为女性,接受ETN治疗。所有参与者都接受了全面的实验室检查、体重指数(BMI)、使用银屑病面积严重性指数(PASI)测量皮肤病严重程度,并计算了皮损减少 75% 的情况(PASI 75):研究 12 周后,MTX 组的体重指数和血压没有明显差异。FBS、TSC、LDL、TRIG、ESR、CRP 和 PASI 的值有所下降,但下降幅度在统计学上并不显著。有 10 名患者(23.8%)的 PASI 达到 75。在 ETN 组中,除体重指数、收缩压和舒张压外,所有其他代谢综合征成分、炎症指标和 PASI 均有所下降;下降幅度在统计学上有显著意义。60例(80%)患者的PASI达到75:结论:在治疗中度至重度斑块型银屑病方面,依那西普单一疗法优于甲氨蝶呤单一疗法,因为在12周后,依那西普的PASI评分降低幅度更大,PASI达到75的比例更高。在改善相关代谢综合征的所有组成部分方面,依那西普单一疗法优于甲氨蝶呤单一疗法,但体重指数(BMI)除外,接受依那西普治疗的患者体重指数会升高。
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引用次数: 0
Correlation between PainDETECT Questionnaire and Quantitative Sensory Testing for the Detection of Neuropathic Pain in Hidradenitis Suppurativa. 用于检测湿疹性化脓性炎神经性疼痛的疼痛检测问卷(PainDETECT Questionnaire)与定量感觉测试之间的相关性
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2023-07-26 DOI: 10.1159/000533262
Patrick J Speck, Ali Alsouhibani, Danielle E Mustin, Emily F Cole, Daniel E Harper, Lauren A V Orenstein

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that is often severely painful due to nociceptive mechanisms (i.e., stimulation of cutaneous nociceptors). However, patient-reported pain character suggests that neuropathy may also drive HS pain in a subset of patients. Quantitative sensory testing (QST) can help identify neuropathic pain by testing for heightened and paradoxical pain responses in patients, but it is less feasible for routine clinical use compared with brief questionnaires. We therefore tested the suitability of a standardized neuropathic questionnaire (PainDETECT; PD-Q) for use as a surrogate clinical measure by directly comparing it with QST-identified neuropathic pain in HS.

Methods: This observational, cross-sectional study included 22 adults with painful HS lesions who completed the PD-Q and underwent QST. A receiver operating characteristic curve was generated and Cohen's Kappa, sensitivity, and specificity were examined at three scoring thresholds.

Results: Of the 22 participants, 14 (64%) exhibited dynamic mechanical allodynia and/or paradoxical thermal sensations in QST, which are characteristically found in neuropathic pain. According to the PD-Q, 8 participants (36%) were unlikely, 8 (36%) were possible, and 6 (27%) were likely to have neuropathic pain. A PD-Q Score indicating possible or likely neuropathic pain (i.e., ≥13) demonstrated 82% agreement with QST-determined neuropathic pain (Cohen's Kappa = 0.61 [p = 0.004]; sensitivity = 86%; specificity = 75%).

Conclusion: The PD-Q demonstrates moderate agreement with QST in screening for neuropathic pain in HS and may be a helpful clinical tool.

背景:化脓性扁平湿疹(HS)是一种慢性炎症性皮肤病,通常会因痛觉机制(即刺激皮肤痛觉感受器)引起剧烈疼痛。然而,患者报告的疼痛特征表明,神经病变也可能导致部分患者出现 HS 疼痛。定量感觉测试(QST)可通过测试患者疼痛反应的增强和矛盾来帮助识别神经病理性疼痛,但与简短的问卷调查相比,它在常规临床应用中的可行性较低。因此,我们通过直接比较标准化神经病理性问卷(PainDETECT;PD-Q)与 QST 在 HS 中识别出的神经病理性疼痛,测试了该问卷是否适合用作临床代用指标:这项观察性横断面研究纳入了 22 名患有 HS 疼痛性病变的成人,他们填写了 PD-Q,并接受了 QST 检查。结果:在 22 名参与者中,14 人(64%)接受了 PD-Q 和 QST:结果:在 22 名参与者中,有 14 人(64%)在 QST 中表现出动态机械异感和/或矛盾热感,这是神经病理性疼痛的特征。根据 PD-Q,8 名参与者(36%)不可能患有神经病理性疼痛,8 名(36%)可能患有神经病理性疼痛,6 名(27%)可能患有神经病理性疼痛。PD-Q 评分表明可能或可能存在神经病理性疼痛(即≥13 分)与 QST 确定的神经病理性疼痛有 82% 的一致性(Cohen's Kappa = 0.61 [p = 0.004];灵敏度 = 86%;特异性 = 75%):结论:在筛查 HS 神经病理性疼痛方面,PD-Q 与 QST 具有中等程度的一致性,可能是一种有用的临床工具。
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引用次数: 0
Alitretinoin as a Treatment Modality for Ichthyosis in Women of Childbearing Age: A Case Series and Review of the Literature. 将阿维A酸作为育龄妇女鱼鳞病的一种治疗方式:病例系列和文献综述。
IF 3 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2023-09-04 DOI: 10.1159/000533934
Julia Clabbers, Noor van van Oosten, Marieke Bolling, Maaike Vreeburg, Michel van Geel, Peter Steijlen, Antoni Gostynski

Background: Acitretin, a synthetic vitamin A derivative, is the most studied and widely used oral retinoid for ichthyoses. Its major disadvantage is the need for contraceptive measures during 3 years after discontinuation. An alternative is needed for women of childbearing age. With alitretinoin, another retinoid, pregnancy is considered safe 1 month after discontinuation.

Objectives: The aim of this study was to provide evidence for alitretinoin as an alternative for acitretin for ichthyosis in women of childbearing age. Our experience is shared in a case series combined with an overview of the current literature.

Methods: Nine women of childbearing age (19-31 years, median 21) with different subtypes of ichthyosis (autosomal recessive congenital ichthyosis, (superficial) epidermolytic ichthyosis, erythrokeratoderma variabilis, and epidermolytic epidermal nevi, a mosaic form of epidermolytic ichthyosis) were included and treated with 30 mg alitretinoin during 2-28 months. Severity was measured by Ichthyosis Area Severity Index (IASI) and Investigator Global Assessment (IGA). A literature search in Pubmed using the Mesh terms "alitretinoin," "skin diseases, genetic" and "ichthyosis" was performed.

Results: Significant reduction in the mean scores of IGA, IASI-erythema, IASI-scaling, and IASI-total was seen. Seven patients are still being treated, 1 patient stopped to become pregnant, 1 patient discontinued due to financial reasons. Observed side effects were reversible headache (n = 6), asteatotic eczema (n = 1), "not feeling well" temporarily (n = 1), and easier blistering of the feet (n = 1). The literature search resulted in six case reports and case series about alitretinoin in ichthyosis and ichthyosis syndromes with in total 29 patients. The vast majority of articles (21/29) reported significant improvement or even complete remission of skin symptoms. However, validated outcome measures to support these results were lacking. Side effects (n = 16) were relatively mild, except for benign intracranial hypertension (n = 1) and autoimmune hypothyroidism (n = 1).

Conclusion: Our study shows, with validated outcome measures, that alitretinoin is effective to mitigate the symptoms of ichthyosis in women of childbearing age and a suitable alternative to acitretin.

背景:阿维A酸是一种人工合成的维生素A衍生物,是目前研究最多、应用最广泛的治疗鱼鳞病的口服维甲酸类药物。它的主要缺点是停药后三年内需要采取避孕措施。育龄妇女需要另一种替代品。对于另一种维甲酸类药物阿维A酸,停药1个月后怀孕被认为是安全的:本研究旨在提供证据,证明阿维A酸可替代阿西曲汀治疗育龄妇女的鱼鳞病。我们通过一个病例系列分享了我们的经验,并对目前的文献进行了综述:九名育龄妇女(19-31 岁,中位数 21 岁)患有不同亚型的鱼鳞病(常染色体隐性先天性鱼鳞病、(表皮)表皮溶解性鱼鳞病、变异性红皮病和表皮溶解性表皮痣,表皮溶解性鱼鳞病的一种镶嵌形式),她们在 2-28 个月期间接受了 30 毫克阿维A酸的治疗。鱼鳞病的严重程度通过鱼鳞病面积严重性指数(IASI)和研究者全面评估(IGA)来衡量。使用 "阿维A酸"、"遗传性皮肤病 "和 "鱼鳞病 "等关键词在Pubmed上进行了文献检索:结果:IGA、IASI-红斑、IASI-鳞屑和 IASI-总分的平均值显著降低。7 名患者仍在接受治疗,1 名患者因怀孕而停止治疗,1 名患者因经济原因停止治疗。观察到的副作用有可逆性头痛(6 例)、骨化性湿疹(1 例)、暂时 "不舒服"(1 例)和脚部更容易起泡(1 例)。通过文献检索,我们找到了六篇有关阿维A酸治疗鱼鳞病和鱼鳞病综合征的病例报告和系列病例,共有29名患者接受了治疗。绝大多数文章(21/29)都报道了皮肤症状明显改善甚至完全缓解的情况。然而,这些结果缺乏经过验证的结果指标来支持。除良性颅内高压(1 例)和自身免疫性甲状腺功能减退(1 例)外,副作用(16 例)相对较轻:我们的研究结果表明,阿维A酸能有效缓解育龄妇女的鱼鳞病症状,是阿西曲汀的合适替代品。
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引用次数: 0
Burgers, Fast Foods, and Increased Associated Risk for Atopic Dermatitis: A Cross-Sectional Study of Dietary Habits among Young Chinese Adults in Singapore/Malaysia. 汉堡、快餐与特应性皮炎相关风险的增加:新加坡/马来西亚年轻华人成年人饮食习惯的横断面研究》(A Cross-Sectional Study of Dietary Habits among Young Chinese Adults in Singapore/Malaysia.
IF 3.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-01-01 Epub Date: 2023-09-04 DOI: 10.1159/000533942
Jun Jie Lim, Yi Ying Eliza Lim, Jun Yan Ng, Praneeth Malipeddi, Yu Ting Ng, Wei Yi Teo, Qi Yi Ambrose Wong, Sri Anusha Matta, Yang Yie Sio, Yi Ru Wong, Keng Foo Teh, Smyrna Moti Rawanan Shah, Kavita Reginald, Yee-How Say, Mei Hui Liu, Fook Tim Chew

Background: We see increasing evidence that dietary and nutrients factors play a pivotal role in allergic diseases and recent global findings suggest that dietary habits influence the pathogenesis of atopic dermatitis (AD). Frequent consumption of fast food diets is associated with AD development. Despite the rising prevalence of AD in Asia, efforts in investigating the role of dietary habits and AD in adults are still lacking.

Methods: We evaluated the association between the dietary intake of 16 food types and AD manifestations using our Singapore/Malaysia Cross-sectional Genetics Epidemiology Study (SMCGES) population. Dietary habits profiles of 11,494 young Chinese adults (1,550 AD cases/2,978 non-atopic controls/6,386 atopic controls) were assessed by an investigator-administered questionnaire. AD cases were further evaluated for their chronicity (550 chronic) and severity (628 moderate-to-severe). Additionally, we derived a novel food index, Quality of Diet based on Glycaemic Index Score (QDGIS), to examine the association between dietary intake of glycaemic index (GI) and various AD phenotypes.

Results: The majority of AD subjects are distributed in the good (37.1%) and moderate (36.2%) QDGIS classes. From the multivariable analyses for age and gender, a moderate QDGIS class was significantly associated with a lower odds of AD (adjusted odds ratio (AOR): 0.844; 95% confidence interval (CI): 0.719-0.991; p < 0.05) and moderate-to-severe AD (AOR: 0.839; 95% CI: 0.714-0.985; p < 0.05). A good QDGIS class was only significantly associated with a lower odds of chronic AD (AOR: 0.769; 95% CI: 0.606-0.976; p < 0.05). Among high GI foods, frequent consumption of burgers/fast food was strongly associated with an increased risk of chronic and moderate-to-severe AD. Among low GI foods, increased intake frequencies of fruits, vegetables, and pulses decreased the odds of AD. Finally, we identified significant associations between frequent seafood, margarine, butter, and pasta consumption with an increased odds of AD despite them having little GI values.

Conclusion: While genetic components are well-established in their risks associated with increased AD prevalence, there is still a lack of a focus epidemiology study associating dietary influence with AD. Based on the first allergic epidemiology study conducted here in Singapore and Malaysia, it laid the groundwork to guide potential dietary interventions from changing personal dietary habits.

背景:越来越多的证据表明,饮食和营养因素在过敏性疾病中起着关键作用,最近的全球研究结果表明,饮食习惯影响特应性皮炎(AD)的发病机制。经常食用快餐与特应性皮炎的发病有关。尽管特应性皮炎在亚洲的发病率不断上升,但仍缺乏对饮食习惯与成人特应性皮炎作用的研究:方法:我们利用新加坡/马来西亚横断面遗传流行病学研究(SMCGES)人群,评估了 16 种食物的饮食摄入量与注意力缺失症表现之间的关联。研究人员通过自制问卷对 11,494 名中国年轻成年人(1,550 例 AD 病例/2,978 例非特应性对照组/6,386 例特应性对照组)的饮食习惯进行了评估。我们进一步评估了AD病例的慢性程度(550例慢性)和严重程度(628例中重度)。此外,我们还得出了一种新的食物指数,即基于血糖指数评分的饮食质量指数(QDGIS),以研究饮食摄入的血糖指数(GI)与各种AD表型之间的关系:结果:大多数 AD 受试者的 QDGIS 分级为良好(37.1%)和中等(36.2%)。在对年龄和性别进行多变量分析后发现,QDGIS 中度分级与较低的 AD(调整后几率比(AOR):0.844;95% 置信区间(CI):0.719-0.991;p <;0.05)和中度至重度 AD(AOR:0.839;95% CI:0.714-0.985;p <;0.05)几率显著相关。良好的 QDGIS 等级仅与较低的慢性 AD 发生几率显著相关(AOR:0.769;95% CI:0.606-0.976;p <;0.05)。在高 GI 食物中,经常食用汉堡/快餐与慢性和中重度 AD 风险的增加密切相关。在低 GI 食物中,水果、蔬菜和豆类摄入频率的增加会降低注意力缺失症的发病几率。最后,我们发现,尽管海鲜、人造黄油、黄油和面食的 GI 值不高,但经常食用这些食物与 AD 的几率增加之间存在明显关联:结论:虽然遗传因素与 AD 患病率增加的相关风险已得到证实,但仍缺乏将饮食影响与 AD 相关联的重点流行病学研究。基于在新加坡和马来西亚开展的首次过敏流行病学研究,该研究为从改变个人饮食习惯入手进行潜在的饮食干预奠定了基础。
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引用次数: 0
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Dermatology
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