Pub Date : 2024-09-25DOI: 10.1001/jamadermatol.2024.3360
Itzel Guadalupe Elizalde-Jiménez, Fernando Gerardo Ruiz-Hernández, Silvia Angélica Carmona-Cruz, Elena Pastrana-Arellano, Alejandra Aquino-Andrade, Carolina Romo-González, Eduardo Arias-de la Garza, Neri Alejandro Álvarez-Villalobos, Maria Teresa García-Romero
Importance: Individuals with atopic dermatitis are frequently colonized and infected with Staphylococcus aureus. Empirical antibiotic therapy for individuals with atopic dermatitis is common, but data about the antimicrobial susceptibility profiles of S aureus strains isolated from these individuals are scarce for those living in particular geographic areas.
Objective: To determine the antimicrobial susceptibility of S aureus from individuals with atopic dermatitis and analyze differences according to the income level of the country of origin and the data collection period.
Data sources: A meta-analysis of the literature was performed from the inception of the included databases (MEDLINE, Embase, Web of Science, Scopus, and Cochrane) to June 20, 2023, using predetermined Medical Subject Headings.
Study selection: Studies were included if they reported antibiotic susceptibility profiles of 1 or more S aureus cutaneous isolates from individuals with atopic dermatitis. Articles written in English, Spanish, French, or German were included.
Data extraction and synthesis: Working in pairs, 6 of the authors conducted the data extraction. The guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed.
Main outcomes and measures: The outcome of interest was antimicrobial susceptibility.
Results: A total of 61 studies reported 4091 S aureus isolates from individuals with atopic dermatitis. For 4 of the 11 commonly used antibiotics (36.4%), antimicrobial susceptibility was 85% or less, including for methicillin (binomial proportion, 0.85 [95% CI, 0.76-0.91]), erythromycin (binomial proportion, 0.73 [95% CI, 0.61-0.83]), fusidic acid (binomial proportion, 0.80 [95% CI, 0.62-0.91]), and clindamycin (binomial proportion, 0.79 [95% CI, 0.65-0.89]). Most studies (46; 75.4%) were conducted in high-income countries. Antimicrobial susceptibility to erythromycin, methicillin, and trimethoprim and sulfamethoxazole was significantly lower in lower middle-income countries and upper middle-income countries. Regarding the temporal trends, 33 studies (54.1%) reported data collected from 1998 to 2010. Antimicrobial susceptibility patterns have not changed over time.
Conclusions and relevance: In this systematic review and meta-analysis, antimicrobial susceptibility of S aureus to β-lactams, erythromycin, clindamycin, and fusidic acid may be suboptimal for empirical use in individuals with atopic dermatitis. Significant differences in antimicrobial susceptibility patterns were found in high-income countries and in lower middle-income countries and upper middle-income countries for some antibiotics.
{"title":"Global Antimicrobial Susceptibility Patterns of Staphylococcus aureus in Atopic Dermatitis: A Systematic Review and Meta-Analysis.","authors":"Itzel Guadalupe Elizalde-Jiménez, Fernando Gerardo Ruiz-Hernández, Silvia Angélica Carmona-Cruz, Elena Pastrana-Arellano, Alejandra Aquino-Andrade, Carolina Romo-González, Eduardo Arias-de la Garza, Neri Alejandro Álvarez-Villalobos, Maria Teresa García-Romero","doi":"10.1001/jamadermatol.2024.3360","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.3360","url":null,"abstract":"<p><strong>Importance: </strong>Individuals with atopic dermatitis are frequently colonized and infected with Staphylococcus aureus. Empirical antibiotic therapy for individuals with atopic dermatitis is common, but data about the antimicrobial susceptibility profiles of S aureus strains isolated from these individuals are scarce for those living in particular geographic areas.</p><p><strong>Objective: </strong>To determine the antimicrobial susceptibility of S aureus from individuals with atopic dermatitis and analyze differences according to the income level of the country of origin and the data collection period.</p><p><strong>Data sources: </strong>A meta-analysis of the literature was performed from the inception of the included databases (MEDLINE, Embase, Web of Science, Scopus, and Cochrane) to June 20, 2023, using predetermined Medical Subject Headings.</p><p><strong>Study selection: </strong>Studies were included if they reported antibiotic susceptibility profiles of 1 or more S aureus cutaneous isolates from individuals with atopic dermatitis. Articles written in English, Spanish, French, or German were included.</p><p><strong>Data extraction and synthesis: </strong>Working in pairs, 6 of the authors conducted the data extraction. The guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were followed.</p><p><strong>Main outcomes and measures: </strong>The outcome of interest was antimicrobial susceptibility.</p><p><strong>Results: </strong>A total of 61 studies reported 4091 S aureus isolates from individuals with atopic dermatitis. For 4 of the 11 commonly used antibiotics (36.4%), antimicrobial susceptibility was 85% or less, including for methicillin (binomial proportion, 0.85 [95% CI, 0.76-0.91]), erythromycin (binomial proportion, 0.73 [95% CI, 0.61-0.83]), fusidic acid (binomial proportion, 0.80 [95% CI, 0.62-0.91]), and clindamycin (binomial proportion, 0.79 [95% CI, 0.65-0.89]). Most studies (46; 75.4%) were conducted in high-income countries. Antimicrobial susceptibility to erythromycin, methicillin, and trimethoprim and sulfamethoxazole was significantly lower in lower middle-income countries and upper middle-income countries. Regarding the temporal trends, 33 studies (54.1%) reported data collected from 1998 to 2010. Antimicrobial susceptibility patterns have not changed over time.</p><p><strong>Conclusions and relevance: </strong>In this systematic review and meta-analysis, antimicrobial susceptibility of S aureus to β-lactams, erythromycin, clindamycin, and fusidic acid may be suboptimal for empirical use in individuals with atopic dermatitis. Significant differences in antimicrobial susceptibility patterns were found in high-income countries and in lower middle-income countries and upper middle-income countries for some antibiotics.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1001/jamadermatol.2024.3349
Andrea D Maderal, Alisa Femia
{"title":"Clinical Application of New Risk-Based Cancer Screening in Patients With Dermatomyositis.","authors":"Andrea D Maderal, Alisa Femia","doi":"10.1001/jamadermatol.2024.3349","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.3349","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1001/jamadermatol.2024.3435
Tian-Yi Zhang, Tao Qu
{"title":"Treatment of Annular Elastolytic Giant Cell Granuloma With Tofacitinib.","authors":"Tian-Yi Zhang, Tao Qu","doi":"10.1001/jamadermatol.2024.3435","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.3435","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1001/jamadermatol.2024.3173
Surya A Veerabagu, Kai-Ping Liao, Anokhi Jambusaria-Pahlajani, Lee Wheless, Mackenzie R Wehner
{"title":"Dermatology Encounters After Solid Organ Transplant.","authors":"Surya A Veerabagu, Kai-Ping Liao, Anokhi Jambusaria-Pahlajani, Lee Wheless, Mackenzie R Wehner","doi":"10.1001/jamadermatol.2024.3173","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.3173","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Importance: China carries a heavy burden of postherpetic neuralgia, with an unmet need for novel drugs with greater efficacy and less prominent neurotoxic effects than existing calcium channel ligands.
Objective: To investigate the efficacy and safety of crisugabalin, an oral calcium channel α2δ-1 subunit ligand, for postherpetic neuralgia.
Design, setting, and participants: This randomized clinical trial, carried out between November 9, 2021, and January 5, 2023, at 48 tertiary care centers across China had 2 parts. Part 1 was a phase 3, multicenter, randomized, double-blind, placebo-controlled, parallel-group study consisting of a 2-week screening period, a 7-day run-in period, and a 12-week double-blind treatment period. Part 2 was a 14-week open-label extension study. Investigators, statisticians, trial clinicians, and patients were blinded to trial group assignments. Participants included adults with postherpetic neuralgia with an average daily pain score (ADPS) of at least 4 on the 11-point Numeric Pain Rating Scale over the preceding week, with the exclusion of patients with pain not controlled by prior therapy with pregabalin (≥300 mg/d) or gabapentin (≥1200 mg/d).
Interventions: Patients were randomized 1:1:1 to receive crisugabalin, 20 mg twice daily (ie, 40 mg/d), and crisugabalin, 40 mg twice daily (ie, 80 mg/d), or placebo for 12 weeks. Eligible patients received crisugabalin, 40 mg, twice daily during extension.
Main outcome and measure: The primary efficacy end point was the change from baseline in ADPS at week 12.
Results: The study enrolled 366 patients (121 patients receiving crisugabalin, 40 mg/d; 121 patients receiving crisugabalin, 80 mg/d; 124 patients receiving placebo; median [IQR] age, 63.0 [56.0-69.0] years; 193 men [52.7%]). At week 12, the least squares mean (SD) change from baseline in ADPS was -2.2 (0.2) for crisugabalin, 40 mg/d, and -2.6 (0.2) for crisugabalin, 80 mg/d, vs -1.1 (0.2) for placebo, with a least squares mean difference of -1.1 (95% CI, -1.6 to -0.7; P < .001) and -1.5 (-95% CI, -2.0 to -1.0; P < .001) vs placebo, respectively. No new safety concerns emerged.
Conclusions and relevance: Crisugabalin, 40 mg/d, or crisugabalin, 80 mg/d, was well tolerated and demonstrated a statistically significant improvement in ADPS over placebo.
{"title":"Efficacy and Safety of Crisugabalin (HSK16149) in Adults with Postherpetic Neuralgia: A Phase 3 Randomized Clinical Trial.","authors":"Daying Zhang, Tiechi Lei, Lanying Qin, Chenyu Li, Xuewu Lin, Huiping Wang, Guoqiang Zhang, Shoumin Zhang, Kemei Shi, Linfeng Li, Zhenling Yang, Xiumin Yang, Xiaohong Ba, Ying Gao, Zhuobo Zhang, Guonian Wang, Liming Wu, Yaping Wang, Yu Wang, Shoumin Zhu, Jihai Shi, Zhijian Ye, Chunjun Yang, Changyi Liu, Tong Zhang, Shousi Lu, Nan Yu, Xiangkui Li, Xiuping Han, Xiaoyan Chen, Li Wan, Zhigang Cheng, Nianyue Bai, Zhehu Jin, Chunshui Yu, Weiyi Zhang, Jianyun Lu, Dongmei Wang, Hui Sun, Wenzhong Wu, Pingping Qin, Zhiying Feng, Rixin Chen, Tangde Zhang, Dong Yang, Wenhao Yin, Jianglin Zhang, Xin Li, Fangqiong Li, Tingting Wu, Qianjin Lu","doi":"10.1001/jamadermatol.2024.3410","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.3410","url":null,"abstract":"<p><strong>Importance: </strong>China carries a heavy burden of postherpetic neuralgia, with an unmet need for novel drugs with greater efficacy and less prominent neurotoxic effects than existing calcium channel ligands.</p><p><strong>Objective: </strong>To investigate the efficacy and safety of crisugabalin, an oral calcium channel α2δ-1 subunit ligand, for postherpetic neuralgia.</p><p><strong>Design, setting, and participants: </strong>This randomized clinical trial, carried out between November 9, 2021, and January 5, 2023, at 48 tertiary care centers across China had 2 parts. Part 1 was a phase 3, multicenter, randomized, double-blind, placebo-controlled, parallel-group study consisting of a 2-week screening period, a 7-day run-in period, and a 12-week double-blind treatment period. Part 2 was a 14-week open-label extension study. Investigators, statisticians, trial clinicians, and patients were blinded to trial group assignments. Participants included adults with postherpetic neuralgia with an average daily pain score (ADPS) of at least 4 on the 11-point Numeric Pain Rating Scale over the preceding week, with the exclusion of patients with pain not controlled by prior therapy with pregabalin (≥300 mg/d) or gabapentin (≥1200 mg/d).</p><p><strong>Interventions: </strong>Patients were randomized 1:1:1 to receive crisugabalin, 20 mg twice daily (ie, 40 mg/d), and crisugabalin, 40 mg twice daily (ie, 80 mg/d), or placebo for 12 weeks. Eligible patients received crisugabalin, 40 mg, twice daily during extension.</p><p><strong>Main outcome and measure: </strong>The primary efficacy end point was the change from baseline in ADPS at week 12.</p><p><strong>Results: </strong>The study enrolled 366 patients (121 patients receiving crisugabalin, 40 mg/d; 121 patients receiving crisugabalin, 80 mg/d; 124 patients receiving placebo; median [IQR] age, 63.0 [56.0-69.0] years; 193 men [52.7%]). At week 12, the least squares mean (SD) change from baseline in ADPS was -2.2 (0.2) for crisugabalin, 40 mg/d, and -2.6 (0.2) for crisugabalin, 80 mg/d, vs -1.1 (0.2) for placebo, with a least squares mean difference of -1.1 (95% CI, -1.6 to -0.7; P < .001) and -1.5 (-95% CI, -2.0 to -1.0; P < .001) vs placebo, respectively. No new safety concerns emerged.</p><p><strong>Conclusions and relevance: </strong>Crisugabalin, 40 mg/d, or crisugabalin, 80 mg/d, was well tolerated and demonstrated a statistically significant improvement in ADPS over placebo.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05140863.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1001/jamadermatol.2024.3897
Joel M Gelfand, April W Armstrong, Henry W Lim, Steven R Feldman, Sandra M Johnson, W C Cole Claiborne, Robert E Kalb, Jeannette Jakus, Aaron R Mangold, R Hal Flowers, Tina Bhutani, John R Durkin, Jerry Bagel, Scott Fretzin, Michael P Sheehan, James Krell, Margo Reeder, Jessica Kaffenberger, Francisca Kartono, Junko Takeshita, Alisha M Bridges, Eric Fielding, Umbereen S Nehal, Kenneth L Schaecher, Leah M Howard, Guy S Eakin, Suzette Báez, Brooke E Bishop, Robert C Fitzsimmons, Maryte Papadopoulos, William B Song, Kristin A Linn, Rebecca A Hubbard, Daniel B Shin, Kristina Callis Duffin
<p><strong>Importance: </strong>Office-based phototherapy is cost-effective for psoriasis but difficult to access. Home-based phototherapy is patient preferred but has limited clinical data, particularly in patients with darker skin.</p><p><strong>Objective: </strong>To compare the effectiveness of home- vs office-based narrowband UV-B phototherapy for psoriasis.</p><p><strong>Design, setting, and participants: </strong>The Light Treatment Effectiveness study was an investigator-initiated, pragmatic, open-label, parallel-group, multicenter, noninferiority randomized clinical trial embedded in routine care at 42 academic and private clinical dermatology practices in the US. Enrollment occurred from March 1, 2019, to December 4, 2023, with follow-up through June 2024. Participants were 12 years and older with plaque or guttate psoriasis who were candidates for home- and office-based phototherapy.</p><p><strong>Interventions: </strong>Participants were randomized to receive a home narrowband UV-B machine with guided mode dosimetry or routine care with office-based narrowband UV-B for 12 weeks, followed by an additional 12-week observation period.</p><p><strong>Main outcomes and measures: </strong>The coprimary effectiveness outcomes were Physician Global Assessment (PGA) dichotomized as clear/almost clear skin (score of ≤1) at the end of the intervention period and Dermatology Life Quality Index (DLQI) score of 5 or lower (no to small effect on quality of life) at week 12.</p><p><strong>Results: </strong>Of 783 patients enrolled (mean [SD] age, 48.0 [15.5] years; 376 [48.0%] female), 393 received home-based phototherapy and 390 received office-based phototherapy, with 350 (44.7%) having skin phototype (SPT) I/II, 350 (44.7%) having SPT III/IV, and 83 (10.6%) having SPT V/VI. A total of 93 patients (11.9%) were receiving systemic treatment. At baseline, mean (SD) PGA was 2.7 (0.8) and DLQI was 12.2 (7.2). At week 12, 129 patients (32.8%) receiving home-based phototherapy and 100 patients (25.6%) receiving office-based phototherapy achieved clear/almost clear skin, and 206 (52.4%) and 131 (33.6%) achieved DLQI of 5 or lower, respectively. Home-based phototherapy was noninferior to office-based phototherapy for PGA and DLQI in the overall population and across all SPTs. Home-based phototherapy, compared to office-based phototherapy, was associated with better treatment adherence (202 patients [51.4%] vs 62 patients [15.9%]; P < .001), lower burden of indirect costs to patients, and more episodes of persistent erythema (466 of 7957 treatments [5.9%] vs 46 of 3934 treatments [1.2%]; P < .001). Both treatments were well tolerated with no discontinuations due to adverse events.</p><p><strong>Conclusions and relevance: </strong>In this randomized clinical trial, home-based phototherapy was as effective as office-based phototherapy for plaque or guttate psoriasis in everyday clinical practice and had less burden to patients.</p><p><strong>Trial registration:
{"title":"Home- vs Office-Based Narrowband UV-B Phototherapy for Patients With Psoriasis: The LITE Randomized Clinical Trial.","authors":"Joel M Gelfand, April W Armstrong, Henry W Lim, Steven R Feldman, Sandra M Johnson, W C Cole Claiborne, Robert E Kalb, Jeannette Jakus, Aaron R Mangold, R Hal Flowers, Tina Bhutani, John R Durkin, Jerry Bagel, Scott Fretzin, Michael P Sheehan, James Krell, Margo Reeder, Jessica Kaffenberger, Francisca Kartono, Junko Takeshita, Alisha M Bridges, Eric Fielding, Umbereen S Nehal, Kenneth L Schaecher, Leah M Howard, Guy S Eakin, Suzette Báez, Brooke E Bishop, Robert C Fitzsimmons, Maryte Papadopoulos, William B Song, Kristin A Linn, Rebecca A Hubbard, Daniel B Shin, Kristina Callis Duffin","doi":"10.1001/jamadermatol.2024.3897","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.3897","url":null,"abstract":"<p><strong>Importance: </strong>Office-based phototherapy is cost-effective for psoriasis but difficult to access. Home-based phototherapy is patient preferred but has limited clinical data, particularly in patients with darker skin.</p><p><strong>Objective: </strong>To compare the effectiveness of home- vs office-based narrowband UV-B phototherapy for psoriasis.</p><p><strong>Design, setting, and participants: </strong>The Light Treatment Effectiveness study was an investigator-initiated, pragmatic, open-label, parallel-group, multicenter, noninferiority randomized clinical trial embedded in routine care at 42 academic and private clinical dermatology practices in the US. Enrollment occurred from March 1, 2019, to December 4, 2023, with follow-up through June 2024. Participants were 12 years and older with plaque or guttate psoriasis who were candidates for home- and office-based phototherapy.</p><p><strong>Interventions: </strong>Participants were randomized to receive a home narrowband UV-B machine with guided mode dosimetry or routine care with office-based narrowband UV-B for 12 weeks, followed by an additional 12-week observation period.</p><p><strong>Main outcomes and measures: </strong>The coprimary effectiveness outcomes were Physician Global Assessment (PGA) dichotomized as clear/almost clear skin (score of ≤1) at the end of the intervention period and Dermatology Life Quality Index (DLQI) score of 5 or lower (no to small effect on quality of life) at week 12.</p><p><strong>Results: </strong>Of 783 patients enrolled (mean [SD] age, 48.0 [15.5] years; 376 [48.0%] female), 393 received home-based phototherapy and 390 received office-based phototherapy, with 350 (44.7%) having skin phototype (SPT) I/II, 350 (44.7%) having SPT III/IV, and 83 (10.6%) having SPT V/VI. A total of 93 patients (11.9%) were receiving systemic treatment. At baseline, mean (SD) PGA was 2.7 (0.8) and DLQI was 12.2 (7.2). At week 12, 129 patients (32.8%) receiving home-based phototherapy and 100 patients (25.6%) receiving office-based phototherapy achieved clear/almost clear skin, and 206 (52.4%) and 131 (33.6%) achieved DLQI of 5 or lower, respectively. Home-based phototherapy was noninferior to office-based phototherapy for PGA and DLQI in the overall population and across all SPTs. Home-based phototherapy, compared to office-based phototherapy, was associated with better treatment adherence (202 patients [51.4%] vs 62 patients [15.9%]; P < .001), lower burden of indirect costs to patients, and more episodes of persistent erythema (466 of 7957 treatments [5.9%] vs 46 of 3934 treatments [1.2%]; P < .001). Both treatments were well tolerated with no discontinuations due to adverse events.</p><p><strong>Conclusions and relevance: </strong>In this randomized clinical trial, home-based phototherapy was as effective as office-based phototherapy for plaque or guttate psoriasis in everyday clinical practice and had less burden to patients.</p><p><strong>Trial registration:","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1001/jamadermatol.2024.3315
James J. Abbott, Angela J. Jiang, Rama Godse, Sarah Ahmed, Stephen C. Senft, Melissa A. Wilson, Justine V. Cohen, Tara C. Mitchell, Temitayo A. Ogunleye, H. William Higgins, Thuzar M. Shin, Christopher J. Miller, Jacquelyn J. Roth, Salvatore F. Priore, Leslie Castelo-Soccio, Rosalie Elenitsas, John T. Seykora, Katherine L. Nathanson, Emily Y. Chu
ImportanceGermline SUFU pathogenic variants (PVs) have previously been associated with basal cell nevus syndrome (BCNS) and multiple infundibulocystic basal cell carcinoma syndrome; however, a broader spectrum of cutaneous findings in patients with SUFU PVs has not been well delineated.ObjectiveTo define the clinical and histopathologic spectrum of cutaneous findings in patients with germline SUFU PVs.Design, Setting, and ParticipantsThis case series was conducted in multiple US academic dermatology, medical genetics, and medical oncology clinics between July 2014 and July 2022. The study included patients with confirmed germline SUFU PVs who were evaluated by a dermatologist. The analysis took place from March to September 2023.Main Outcomes and MeasuresHistopathologic evaluation of skin biopsies with or without immunohistochemical staining, and targeted next-generation sequencing (NGS) on tumor specimens.ResultsAll 5 patients were women. The mean (range) age at presentation was 50.2 (31-68) years, with skin manifestations initially appearing in the fourth to sixth decades of life. None had keratocystic odontogenic tumors. A total of 29 skin pathology specimens from the 5 patients were reviewed; of these, 3 (10.3%) were diagnosed as basaloid follicular hamartomas (BFHs), 10 (34.5%) classified as infundibulocystic basal cell carcinomas (iBCCs), 6 (20.7%) classified as nodular basal cell carcinomas (nBCCs), and 1 (3.4%) as infiltrative basal cell carcinoma (BCC). Targeted NGS studies on tumor specimens suggest that an increased number of UV-signature variants is associated with basal cell carcinomas compared with more indolent basaloid follicular hamartomas.Conclusions and RelevancePatients with germline SUFU PVs may present with multiple indolent basaloid neoplasms in addition to conventional basal cell carcinomas, typically appearing in the fourth to sixth decades of life. Although there are overlapping clinical manifestations, these findings help to differentiate the clinical syndrome associated with SUFU PVs from PTCH1 BCNS. Awareness of the clinicopathologic spectrum of SUFU-associated basaloid neoplasms is important for dermatologists and dermatopathologists because many (although not all) of these lesions are indolent and do not require aggressive surgical treatment. Importantly, because SUFU lies downstream of the protein smoothened, vismodegib and other smoothened inhibitors are unlikely to be effective therapies in this subset of patients.
{"title":"Inherited Basaloid Neoplasms Associated With SUFU Pathogenic Variants","authors":"James J. Abbott, Angela J. Jiang, Rama Godse, Sarah Ahmed, Stephen C. Senft, Melissa A. Wilson, Justine V. Cohen, Tara C. Mitchell, Temitayo A. Ogunleye, H. William Higgins, Thuzar M. Shin, Christopher J. Miller, Jacquelyn J. Roth, Salvatore F. Priore, Leslie Castelo-Soccio, Rosalie Elenitsas, John T. Seykora, Katherine L. Nathanson, Emily Y. Chu","doi":"10.1001/jamadermatol.2024.3315","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.3315","url":null,"abstract":"ImportanceGermline <jats:italic>SUFU</jats:italic> pathogenic variants (PVs) have previously been associated with basal cell nevus syndrome (BCNS) and multiple infundibulocystic basal cell carcinoma syndrome; however, a broader spectrum of cutaneous findings in patients with <jats:italic>SUFU</jats:italic> PVs has not been well delineated.ObjectiveTo define the clinical and histopathologic spectrum of cutaneous findings in patients with germline <jats:italic>SUFU</jats:italic> PVs.Design, Setting, and ParticipantsThis case series was conducted in multiple US academic dermatology, medical genetics, and medical oncology clinics between July 2014 and July 2022. The study included patients with confirmed germline <jats:italic>SUFU</jats:italic> PVs who were evaluated by a dermatologist. The analysis took place from March to September 2023.Main Outcomes and MeasuresHistopathologic evaluation of skin biopsies with or without immunohistochemical staining, and targeted next-generation sequencing (NGS) on tumor specimens.ResultsAll 5 patients were women. The mean (range) age at presentation was 50.2 (31-68) years, with skin manifestations initially appearing in the fourth to sixth decades of life. None had keratocystic odontogenic tumors. A total of 29 skin pathology specimens from the 5 patients were reviewed; of these, 3 (10.3%) were diagnosed as basaloid follicular hamartomas (BFHs), 10 (34.5%) classified as infundibulocystic basal cell carcinomas (iBCCs), 6 (20.7%) classified as nodular basal cell carcinomas (nBCCs), and 1 (3.4%) as infiltrative basal cell carcinoma (BCC). Targeted NGS studies on tumor specimens suggest that an increased number of UV-signature variants is associated with basal cell carcinomas compared with more indolent basaloid follicular hamartomas.Conclusions and RelevancePatients with germline <jats:italic>SUFU</jats:italic> PVs may present with multiple indolent basaloid neoplasms in addition to conventional basal cell carcinomas, typically appearing in the fourth to sixth decades of life. Although there are overlapping clinical manifestations, these findings help to differentiate the clinical syndrome associated with <jats:italic>SUFU</jats:italic> PVs from <jats:italic>PTCH1</jats:italic> BCNS. Awareness of the clinicopathologic spectrum of <jats:italic>SUFU</jats:italic>-associated basaloid neoplasms is important for dermatologists and dermatopathologists because many (although not all) of these lesions are indolent and do not require aggressive surgical treatment. Importantly, because SUFU lies downstream of the protein smoothened, vismodegib and other smoothened inhibitors are unlikely to be effective therapies in this subset of patients.","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1001/jamadermatol.2024.3104
Nicole Mastacouris, Bria Midgette, Andrew Strunk, Amit Garg
{"title":"Precocious Puberty Among Children and Adolescents With Hidradenitis Suppurativa.","authors":"Nicole Mastacouris, Bria Midgette, Andrew Strunk, Amit Garg","doi":"10.1001/jamadermatol.2024.3104","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.3104","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1001/jamadermatol.2024.2970
Adam J N Raymakers, Aaron S Kesselheim, William B Feldman
{"title":"Estimating Costs in Beremagene Geperpavec for Dystrophic Epidermolysis Bullosa-Reply.","authors":"Adam J N Raymakers, Aaron S Kesselheim, William B Feldman","doi":"10.1001/jamadermatol.2024.2970","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.2970","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-18DOI: 10.1001/jamadermatol.2024.2722
Sierra Parkinson, Sabah Osmani, Paul B. Googe, Donna A. Culton
This case report describes a man in his 50s with a diffuse pruritic rash after initiating treatment with pembrolizumab and enfortumab vedotin for metastatic urothelial carcinoma.
{"title":"Treatment of Pembrolizumab-Induced Mucocutaneous Lichen Planus With Metronidazole","authors":"Sierra Parkinson, Sabah Osmani, Paul B. Googe, Donna A. Culton","doi":"10.1001/jamadermatol.2024.2722","DOIUrl":"https://doi.org/10.1001/jamadermatol.2024.2722","url":null,"abstract":"This case report describes a man in his 50s with a diffuse pruritic rash after initiating treatment with pembrolizumab and enfortumab vedotin for metastatic urothelial carcinoma.","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142249598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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