Pub Date : 2013-08-01DOI: 10.1586/17469872.2013.816497
S. Tambe, S. Häfliger, L. Borradori
Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease associated with autoantibodies directed against two components of junctional adhesion complexes in stratified epithelia, BPAG2 and BPAG1-e. BP typically develops in the elderly and manifests with widespread eczematous, urticated and bullous lesions. In up to 20% of the affected patients, obvious blistering is lacking and the clinical features of BP are misleading and closely mimic a variety of other inflammatory conditions. Diagnosis of BP, which should be rather called cutaneous pemphigoid, relies on direct immunofluorescence microscopy studies to detect tissue-bound IgG and/or C3 immune deposits along the epidermal basement membrane zone. Here, the clinical presentations of BP and the diagnostic algorithm with the immunopathological studies available to classify affected patients are reviewed. Finally, the need for widely accepted criteria for the classification of BP patients is emphasized, since in a number of patients with featu...
{"title":"Clinical challenges and recent advances in the diagnosis of bullous pemphigoid","authors":"S. Tambe, S. Häfliger, L. Borradori","doi":"10.1586/17469872.2013.816497","DOIUrl":"https://doi.org/10.1586/17469872.2013.816497","url":null,"abstract":"Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease associated with autoantibodies directed against two components of junctional adhesion complexes in stratified epithelia, BPAG2 and BPAG1-e. BP typically develops in the elderly and manifests with widespread eczematous, urticated and bullous lesions. In up to 20% of the affected patients, obvious blistering is lacking and the clinical features of BP are misleading and closely mimic a variety of other inflammatory conditions. Diagnosis of BP, which should be rather called cutaneous pemphigoid, relies on direct immunofluorescence microscopy studies to detect tissue-bound IgG and/or C3 immune deposits along the epidermal basement membrane zone. Here, the clinical presentations of BP and the diagnostic algorithm with the immunopathological studies available to classify affected patients are reviewed. Finally, the need for widely accepted criteria for the classification of BP patients is emphasized, since in a number of patients with featu...","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90672498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-08-01DOI: 10.1586/17469872.2013.814872
B. Elewski
Onychomycosis is a common nail infection for which treatment options are limited, and no new treatment have been introduced for over 10 years. While patients might prefer a topical therapy, efficacy with ciclopirox and amorolfine lacquers has been disappointing especially in moderate to severe disease. Efinaconazole 10% solution is a new triazole antifungal, specifically developed for the topical treatment of onychomycosis. Its physicochemical properties, antifungal activity and formulation are all important aspects of the development program and are reviewed here. Efinaconazole 10% solution may provide the first viable alternative to oral therapy for onychomycosis. Mycologic cure rates are comparable to those seen with oral itraconazole, and greater than reported with ciclopirox lacquer.
{"title":"Efinaconazole 10% solution: a new topical antifungal therapy for onychomycosis","authors":"B. Elewski","doi":"10.1586/17469872.2013.814872","DOIUrl":"https://doi.org/10.1586/17469872.2013.814872","url":null,"abstract":"Onychomycosis is a common nail infection for which treatment options are limited, and no new treatment have been introduced for over 10 years. While patients might prefer a topical therapy, efficacy with ciclopirox and amorolfine lacquers has been disappointing especially in moderate to severe disease. Efinaconazole 10% solution is a new triazole antifungal, specifically developed for the topical treatment of onychomycosis. Its physicochemical properties, antifungal activity and formulation are all important aspects of the development program and are reviewed here. Efinaconazole 10% solution may provide the first viable alternative to oral therapy for onychomycosis. Mycologic cure rates are comparable to those seen with oral itraconazole, and greater than reported with ciclopirox lacquer.","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85445430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-08-01DOI: 10.1586/17469872.2013.814861
Chelsea Cooper, L. Sholl, P. Gerami
At the molecular level, melanoma and nevi exhibit distinct chromosomal copy number aberrations. As a result, the addition of molecular techniques such as FISH may improve the diagnostic procedures for melanocytic neoplasms. FISH probes targeting 6p25, 11q13, 6q23, 9p21, 8q24 and CEP 6 are currently used in the diagnosis of melanoma. While these assays can be of great utility, there are challenges that may emerge in optimizing interpretation. In this review, the authors discuss technical challenges commonly associated with the FISH protocol such as overdigestion, underdigestion and excessive background. The authors also present challenges associated with interpretation of the FISH for chromosomal copy number changes and offer suggestions as to how the effects of these difficulties can be minimized.
{"title":"Challenges involved in the diagnostic interpretation of FISH for melanocytic neoplasms","authors":"Chelsea Cooper, L. Sholl, P. Gerami","doi":"10.1586/17469872.2013.814861","DOIUrl":"https://doi.org/10.1586/17469872.2013.814861","url":null,"abstract":"At the molecular level, melanoma and nevi exhibit distinct chromosomal copy number aberrations. As a result, the addition of molecular techniques such as FISH may improve the diagnostic procedures for melanocytic neoplasms. FISH probes targeting 6p25, 11q13, 6q23, 9p21, 8q24 and CEP 6 are currently used in the diagnosis of melanoma. While these assays can be of great utility, there are challenges that may emerge in optimizing interpretation. In this review, the authors discuss technical challenges commonly associated with the FISH protocol such as overdigestion, underdigestion and excessive background. The authors also present challenges associated with interpretation of the FISH for chromosomal copy number changes and offer suggestions as to how the effects of these difficulties can be minimized.","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89211214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-08-01DOI: 10.1586/17469872.2013.814880
M. Ara, E. Daudén
Etanercept is a systemic tumor necrosis factor-α inhibitor indicated for use in the treatment of rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis and plaque psoriasis. A considerable number of studies have demonstrated the efficacy and safety of etanercept in these indications, thus offering a new and promising treatment option. The drug was approved by the Food and Drug Administration in the United States and by the European Medicines Evaluation Agency in Europe for treating moderate-to-severe psoriasis in 2004. This article reviews the pharmacology, clinical efficacy and safety of etanercept for psoriasis and recent findings since its approval. The number of studies of medium- and long-term efficacy and safety is increasing steadily; these studies support the use of etanercept in a maintenance setting, with an apparently more favorable risk: benefit ratio than traditional systemic treatments.
{"title":"Etanercept for the treatment of psoriasis","authors":"M. Ara, E. Daudén","doi":"10.1586/17469872.2013.814880","DOIUrl":"https://doi.org/10.1586/17469872.2013.814880","url":null,"abstract":"Etanercept is a systemic tumor necrosis factor-α inhibitor indicated for use in the treatment of rheumatoid arthritis, polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis and plaque psoriasis. A considerable number of studies have demonstrated the efficacy and safety of etanercept in these indications, thus offering a new and promising treatment option. The drug was approved by the Food and Drug Administration in the United States and by the European Medicines Evaluation Agency in Europe for treating moderate-to-severe psoriasis in 2004. This article reviews the pharmacology, clinical efficacy and safety of etanercept for psoriasis and recent findings since its approval. The number of studies of medium- and long-term efficacy and safety is increasing steadily; these studies support the use of etanercept in a maintenance setting, with an apparently more favorable risk: benefit ratio than traditional systemic treatments.","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82780947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mycetoma is a serious health problem that is endemic in many tropical and subtropical regions and characterized by devastating deformities, disability and high morbidity. It is a badly neglected disease worldwide. To date, mycetoma’s true incidence, prevalence and route of infection are not well understood; likewise, its susceptibility, resistance and response to medical treatment, which negatively affects patient management. Current treatment, in particular for eumycetoma, has proven to be quite ineffective, have serious side effects and is expensive for patients and health authorities in endemic areas. In general, the eumycetoma treatment outcome is disappointing and is associated with a low cure rate and high amputation and recurrence rates. Late patient presentation is a major problem in mycetoma due to the lack of health education, poor patient socioeconomic status and poor treatment compliance. This is aggravated by a lack of national and international disease awareness, which has led to a massive k...
{"title":"Managing mycetoma: guidelines for best practice","authors":"A. Fahal, A. Elkhawad","doi":"10.1586/EDM.13.31","DOIUrl":"https://doi.org/10.1586/EDM.13.31","url":null,"abstract":"Mycetoma is a serious health problem that is endemic in many tropical and subtropical regions and characterized by devastating deformities, disability and high morbidity. It is a badly neglected disease worldwide. To date, mycetoma’s true incidence, prevalence and route of infection are not well understood; likewise, its susceptibility, resistance and response to medical treatment, which negatively affects patient management. Current treatment, in particular for eumycetoma, has proven to be quite ineffective, have serious side effects and is expensive for patients and health authorities in endemic areas. In general, the eumycetoma treatment outcome is disappointing and is associated with a low cure rate and high amputation and recurrence rates. Late patient presentation is a major problem in mycetoma due to the lack of health education, poor patient socioeconomic status and poor treatment compliance. This is aggravated by a lack of national and international disease awareness, which has led to a massive k...","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81396649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Systemic sclerosis (SSc) is a severe, chronic autoimmune disease of the connective tissue. The disease typically becomes clinically apparent on the skin and subsequently spreads to several internal organs, in particular the gastrointestinal system, lung, heart and kidney (in decreasing frequency). The pathogenesis evolves via activation of the vascular and immune system, finally leading to a fibrotic response of the connective tissue and resulting in progressive dysfunction of the affected organs. Although the etiology still remains elusive, the knowledge of genetic factors associated with SSc has increased remarkably in recent years. It can be shown that SSc shares a number of genetic risk factors with other autoimmune diseases, in particular lupus erythematosus. New pathways such as Wnt signaling have been identified, which improve our understanding of the initiation of fibrosis in this still enigmatic disease. The enhanced insight into distinct steps of the organotypic pathophysiology of SSc, for examp...
{"title":"Developments into understanding the pathogenesis of systemic sclerosis","authors":"N. Hunzelmann","doi":"10.1586/EDM.13.8","DOIUrl":"https://doi.org/10.1586/EDM.13.8","url":null,"abstract":"Systemic sclerosis (SSc) is a severe, chronic autoimmune disease of the connective tissue. The disease typically becomes clinically apparent on the skin and subsequently spreads to several internal organs, in particular the gastrointestinal system, lung, heart and kidney (in decreasing frequency). The pathogenesis evolves via activation of the vascular and immune system, finally leading to a fibrotic response of the connective tissue and resulting in progressive dysfunction of the affected organs. Although the etiology still remains elusive, the knowledge of genetic factors associated with SSc has increased remarkably in recent years. It can be shown that SSc shares a number of genetic risk factors with other autoimmune diseases, in particular lupus erythematosus. New pathways such as Wnt signaling have been identified, which improve our understanding of the initiation of fibrosis in this still enigmatic disease. The enhanced insight into distinct steps of the organotypic pathophysiology of SSc, for examp...","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78226581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hormonal acne: leading to a paradigm shift in the management of acne","authors":"Jayakar Thomas, K. Parimalam, R. Sindhu","doi":"10.1586/EDM.13.21","DOIUrl":"https://doi.org/10.1586/EDM.13.21","url":null,"abstract":"","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81618001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psoriasis is a chronic, immune-mediated inflammatory skin disease that is associated with multiple comorbidities including psoriatic arthritis, cardiometabolic diseases, malignancies, nonalcoholic fatty liver disease, autoimmune diseases, inflammatory-bowel disease, obstructive sleep apnea and chronic obstructive pulmonary disease. Cardiovascular disease including myocardial infarction, stroke and subclinical atherosclerosis as well as obesity, metabolic syndrome, diabetes, hypertension and hyperlipidemia, are associated with psoriasis. Shared inflammatory pathways may be the basis for these disease associations, especially in the case of cardiovascular disease and its risk factors. Reduced quality of life, depression, anxiety, smoking and alcoholism are also seen in psoriasis patients. Awareness and understanding of the relationships between psoriasis and its comorbidities is important in managing patients with psoriasis. The multiple comorbidities associated with psoriasis will be discussed here, focusi...
{"title":"Comorbidities of psoriasis","authors":"S. Churton, Kristen Doud, N. Korman","doi":"10.1586/EDM.13.23","DOIUrl":"https://doi.org/10.1586/EDM.13.23","url":null,"abstract":"Psoriasis is a chronic, immune-mediated inflammatory skin disease that is associated with multiple comorbidities including psoriatic arthritis, cardiometabolic diseases, malignancies, nonalcoholic fatty liver disease, autoimmune diseases, inflammatory-bowel disease, obstructive sleep apnea and chronic obstructive pulmonary disease. Cardiovascular disease including myocardial infarction, stroke and subclinical atherosclerosis as well as obesity, metabolic syndrome, diabetes, hypertension and hyperlipidemia, are associated with psoriasis. Shared inflammatory pathways may be the basis for these disease associations, especially in the case of cardiovascular disease and its risk factors. Reduced quality of life, depression, anxiety, smoking and alcoholism are also seen in psoriasis patients. Awareness and understanding of the relationships between psoriasis and its comorbidities is important in managing patients with psoriasis. The multiple comorbidities associated with psoriasis will be discussed here, focusi...","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86562231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mycosis fungoides (MF) is a low-grade lymphoproliferative disorder that is histologically characterized by an epidermotropic proliferation of small or medium-sized atypical T lymphocytes with cerebriform nuclei and is primarily a disease of the elderly. It is rare in children and adolescents; in large series of MF published in the literature, only a small percentage of patients were observed to have onset of MF below adolescence. It was believed that a younger age of onset of MF may herald a poorer prognosis. Recently, with improved knowledge of the basic nature of the disease and refined diagnostic facilities, a few series of MF among children and adolescence have appeared and have drawn more awareness to the behavior of MF in this age group. This review summarizes the clinicoepidemiological features, treatment and prognosis of MF among children and adolescents based on the current literature.
{"title":"Mycosis fungoides in children and adolescents","authors":"A. Nanda, H. Al-Ajmi","doi":"10.1586/EDM.13.29","DOIUrl":"https://doi.org/10.1586/EDM.13.29","url":null,"abstract":"Mycosis fungoides (MF) is a low-grade lymphoproliferative disorder that is histologically characterized by an epidermotropic proliferation of small or medium-sized atypical T lymphocytes with cerebriform nuclei and is primarily a disease of the elderly. It is rare in children and adolescents; in large series of MF published in the literature, only a small percentage of patients were observed to have onset of MF below adolescence. It was believed that a younger age of onset of MF may herald a poorer prognosis. Recently, with improved knowledge of the basic nature of the disease and refined diagnostic facilities, a few series of MF among children and adolescence have appeared and have drawn more awareness to the behavior of MF in this age group. This review summarizes the clinicoepidemiological features, treatment and prognosis of MF among children and adolescents based on the current literature.","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77291995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Should there be an app for that? Controversies of diagnosing melanoma with your smartphone","authors":"J. F. Moreau, L. Ferris","doi":"10.1586/EDM.13.22","DOIUrl":"https://doi.org/10.1586/EDM.13.22","url":null,"abstract":"","PeriodicalId":12255,"journal":{"name":"Expert Review of Dermatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78461672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：