International Journal of Dermatology最新文献

Managing chronic inflammatory skin diseases such as hidradenitis suppurativa (HS) and psoriasis extends beyond clinical measures; it should also consider patient-reported outcomes, treatment burden, and overall satisfaction. Successful therapy in both conditions is influenced by factors such as residual disease activity, the psychological profiles of patients, and the availability of new treatment options. The coexistence of psoriasis and atopic dermatitis can pose significant diagnostic and therapeutic challenges. In such rare cases, Janus kinase inhibitors may be considered a treatment option instead of biologics.

Hidradenitis suppurativa (HS), or acne inversa, is a chronic inflammatory skin condition primarily affecting skin folds such as the axilla, groins, and the inframammary, perineal, and perianal regions. It is characterized by painful abscesses, sinus tracts, and scarring. Predominantly affecting young adults, particularly females, HS often emerges during reproductive age, and flares are widely reported during pregnancy and postpartum, underscoring the need to consider management strategies tailored to pregnant or lactating individuals. Moreover, the chronic and relapsing nature of HS, along with challenges related to the safety and compliance of medication use during pregnancy and lactation, as well as various comorbidities and psychological distress, significantly complicate its management in pregnant or lactating women. Treatment options, including topical clindamycin, oral clindamycin-rifampicin, adalimumab, metformin, antiseptic washes, and certolizumab pegol, have accumulated evidence supporting their relative safety in pregnant and lactating women. While certolizumab pegol has shown promising safety data among biologics, it requires more efficacy data in HS. Conversely, while newly approved HS medications such as secukinumab and bimekizumab show promise for the general population, further research is necessary to evaluate their safety profiles in pregnant and breastfeeding individuals. The scant research available on HS in pregnant and lactating women, also shown by our systematic literature review, highlights the need for a comprehensive investigation into the safety, efficacy, and suitability of management strategies.

Variations in epidemiology, pathophysiology, genetics, clinical presentation, management, quality of life (QoL) impact, and access to care and research exist globally across the spectrum of individuals with psoriasis. This article aims to provide an evidence-based update on the characteristics of psoriasis in individuals with skin of color (SOC), a population in which psoriasis data have historically been limited. A literature search was conducted from January 2018 until August 2023 in Pubmed/MEDLINE/Cochrane Library and identified studies with I-III level of evidence using Oxford Centre for Evidence-Based Medicine recommendations. Multiple factors (including biological and non-biological) contribute to differences in clinical features and therapeutic nuances in patient populations with SOC. The prevalence of plaque psoriasis is lower in people with SOC but tends to be more severe. People with SOC are less likely to receive biologic treatment. Although the QoL impact of psoriasis is worse in populations with SOC than in White populations, more research is needed to elucidate variations in presentation and impact across diverse populations. An important limitation of this study is that ethnicity, race, and SOC have not been defined universally or used consistently in the literature. Available evidence provides limited information on populations with SOC outside North America, which limits generalizability across global populations. Furthering our understanding of psoriasis in individuals with SOC is crucial to improving patient care outcomes for diverse patient populations worldwide.

In this paper, the European Academy of Dermatology and Venereology (EADV) Task Force on Quality of Life (QoL) and Patient-Oriented Outcomes presents its position statements on health-related (HR) QoL assessment in epidermolysis bullosa (EB). The EADV TF on QoL and Patient-Oriented Outcomes recommends the use of the EB-specific instrument QOLEB in patients over the age of 10 years and, in addition to the QOLEB, the use of iscorEB-p in moderate-to-severe EB; the IntoDermQoL proxy instrument with its EB-specific module should be used in children aged under 5 years. The EB-specific instrument iscorEB-p, and the dermatology-specific instrument CDLQI may measure HRQoL in children with EB aged from 5 to 10 years. Dermatology-specific and/or generic HRQoL instruments should be used to compare the impact on QoL of EB with other diseases; family QoL of patients with EB should be studied using the EB-specific EB-BoD, dermatology-specific family measures, and/or generic family QoL instruments.