European Journal of Dermatology最新文献

Palmoplantar pustulosis (PPP) is a chronic relapsing inflammatory disease of unknown aetiology characterized by erythema, scaling, and aseptic pustules, which pose a significant clinical, psychological, and economic burden to patients. Studies have shown that the tonsils play a key role in the exacerbation and pathogenesis of certain diseases. This paper systematically summarizes the evidence supporting the close association between tonsils and PPP, and proposes mechanisms by which tonsils may contribute to the pathogenesis of PPP. In addition, the paper elucidates the role of tonsillectomy in alleviating PPP, provides a basis for considering it as a treatment option after conventional PPP treatment has failed, and lays the groundwork for an in-depth investigation of the intricate relationship between tonsillectomy and PPP.

Pediatric atopic dermatitis (AD) is a common chronic disease. For assessing treatment outcomes, the concept of controlled and uncontrolled AD has been introduced. The aim of the study was to estimate healthcare resource use in terms of visits, treatments and costs in children with controlled and uncontrolled AD. The study utilised administrative data and hospital patient records. An algorithm for the identification of patients with controlled and uncontrolled AD was developed, and an assessment of content validity was performed. The study included 8,922 children, aged 0-17 years, diagnosed with AD between 2015 and 2018 in three Swedish regions, treated in primary and specialist care, at regional and university hospitals. The proposed algorithm demonstrated adequate content validity. About 13% of children had uncontrolled AD. In dermatology clinics, most patients with uncontrolled disease were 12-17 years old (39%) and 17% had moderate-to-severe AD; 2% had systemic drug treatment and 7% received UVB treatment. Uncontrolled AD was associated with treatment changes and frequent visits in specialist care over several years compared to controlled disease. The mean annual healthcare cost of a child with AD aged 0-17 years in Sweden was estimated at €4,479.5. There was a statistically significant cost difference (around €4000 annually) between patients with uncontrolled AD and those with controlled disease. AD was associated with high healthcare utilization, especially for children with uncontrolled disease. A high proportion of children with AD might be undertreated, and risk groups, such as adolescents with uncontrolled AD, should be treated more effectively.

Tralokinumab is a human monoclonal anti-interleukin-13 antibody approved as systemic treatment for atopic dermatitis (AD). We aimed to evaluate effectiveness and safety of tralokinumab for AD in real-world clinical practice. We analysed Japanese patients with AD from October 2023 to March 2024. All patients were subcutaneously injected with tralokinumab, 300 mg every two weeks, after an initial injection of 600 mg and twice-daily topical corticosteroids of moderate to strongest class until week 12. In this study, 103 patients were analysed. At week 4 and 12, 54.7 % and 83.0 % achieved eczema area and severity index (EASI) 50, 22.7 % and 38.3 % achieved EASI 75, 90 8.0 % and 23.4 % achieved EASI, 32.0 % and 55.3 % achieved EASI ≤7, and 1.3 % and 14.0 % achieved Investigator's Global Assessment 0/1, respectively. At week 4 and 12, 52.9 % and 51.2 % achieved Peak Pruritus-Numerical Rating Scale (PP-NRS) 4, 16.5 % and 15.6 % achieved PP-NRS ≤1, and 57.9 % and 75.0 % achieved Atopic Dermatitis Control Tool 7, respectively. Serum levels of immunoglobulin E, thymus and activation-regulated chemokine, and lactate dehydrogenase significantly decreased at week 12 compared to baseline. Treatment-emergent adverse events occurred in 14.8 % of patients, which were mild and manageable. Notably, conjunctivitis occurred in 2.9 % of patients but was mild and resolved spontaneously. Tralokinumab for patients with AD was well-tolerated and provided favourable therapeutic effects in real-world clinical practice.