Keloids are benign, fibroproliferative dermal tumours, often arising after trauma, that are more common in darker skin types. Numerous therapeutic options have been employed for the treatment of keloids; however, there is no one gold standard approach. Five-fluorouracil, a potent chemotherapeutic agent, has emerged as a promising therapeutic option. Therefore, this systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focused on providing a broad overview of the use of 5-fluorouracil for the management of keloids. Forty studies (2325 patients) met inclusion criteria and investigated 5-fluorouracil for keloid management, with 19 studies (1043 patients) including a 5-fluorouracil monotherapy group. Five-fluorouracil monotherapy demonstrated consistent keloid improvement with >254 keloids injected across various anatomical regions. Five-fluorouracil monotherapy was most often compared to intralesional triamcinolone acetonide, utilizing the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. The most common keloid parameters assessed were height, size, volume, width, length, induration, pruritus, and erythema. Five-fluorouracil monotherapy exhibited substantial improvements, with weight averages of 73% of patients experiencing >25% improvement and 67% achieving >50% improvement. Relapse rate was 16% at 27 weeks after 5-fluorouracil monotherapy treatment. Limitations included potential selection bias, language restrictions, and heterogenous data analysis among studies. Overall, our findings underscore the potential effectiveness of 5-fluorouracil monotherapy in the management of keloids, with an encouraging safety profile. Larger prospective trials are needed to determine optimal therapy or combination therapy for the management of keloids. This detailed compilation of treatment protocols, outcomes, and relapse rates stand as a valuable resource for further research and clinical applications.
{"title":"Intralesional 5-Fluorouracil for Keloids: A Systematic Review.","authors":"Aliyah King, Marina Guirguis, Seyyon Satkunanathan, Mysa Saad, Reetesh Bose","doi":"10.1177/12034754241256346","DOIUrl":"10.1177/12034754241256346","url":null,"abstract":"<p><p>Keloids are benign, fibroproliferative dermal tumours, often arising after trauma, that are more common in darker skin types. Numerous therapeutic options have been employed for the treatment of keloids; however, there is no one gold standard approach. Five-fluorouracil, a potent chemotherapeutic agent, has emerged as a promising therapeutic option. Therefore, this systematic review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focused on providing a broad overview of the use of 5-fluorouracil for the management of keloids. Forty studies (2325 patients) met inclusion criteria and investigated 5-fluorouracil for keloid management, with 19 studies (1043 patients) including a 5-fluorouracil monotherapy group. Five-fluorouracil monotherapy demonstrated consistent keloid improvement with >254 keloids injected across various anatomical regions. Five-fluorouracil monotherapy was most often compared to intralesional triamcinolone acetonide, utilizing the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. The most common keloid parameters assessed were height, size, volume, width, length, induration, pruritus, and erythema. Five-fluorouracil monotherapy exhibited substantial improvements, with weight averages of 73% of patients experiencing >25% improvement and 67% achieving >50% improvement. Relapse rate was 16% at 27 weeks after 5-fluorouracil monotherapy treatment. Limitations included potential selection bias, language restrictions, and heterogenous data analysis among studies. Overall, our findings underscore the potential effectiveness of 5-fluorouracil monotherapy in the management of keloids, with an encouraging safety profile. Larger prospective trials are needed to determine optimal therapy or combination therapy for the management of keloids. This detailed compilation of treatment protocols, outcomes, and relapse rates stand as a valuable resource for further research and clinical applications.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-01-25DOI: 10.1177/12034754241229335
Li-Wen Zhang, Juan Wu
{"title":"Proteus Syndrome.","authors":"Li-Wen Zhang, Juan Wu","doi":"10.1177/12034754241229335","DOIUrl":"10.1177/12034754241229335","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-28DOI: 10.1177/12034754241253192
Oluwatosin Odeshi, Tarek Turk, Loretta Fiorillo, Samuel Lowe, Marlene Dytoc
Background: In recent years, teledermatology has rapidly emerged as a healthcare delivery method with potential implications for managing chronic inflammatory dermatoses like atopic dermatitis (AD).
Objectives: This study assesses the utility of telemedicine in the management of AD by comparing virtual care with traditional in-office visits with the aim of identifying differences in clinical outcomes between these 2 healthcare delivery modalities.
Methods: Patients of all ages with AD were recruited from 2 dermatology practices. Consecutive patients presenting to the clinics who met the inclusion criteria were invited to enrol in the study. Those who consented to participate were randomly assigned to the virtual or in-person arm of the study, with the opportunity to decline care in either study arm. The inclusion criteria required participants to have a confirmed diagnosis of AD. Exclusion criteria included significant comorbidity that might affect the course of treatment, inaccessibility to teleconsults such as not having a camera for video conferences, and self-declared limitations in operating Zoom. Patients were assessed at baseline (week 0), 4 to 6 weeks, and 8 to 12 weeks using 6 efficacy parameters.
Results: In the virtual group, all 6 dermatological measures suggested improved outcomes. Average Body Surface Area scores decreased (β = -.07, 95% CI = -0.1, -0.3) over the course of follow-up. Virtual care patients had 80% lower odds of moderate-to-severe uncontrolled disease (OR = 0.2; 95% CI = 0.06, 0.5) and pruritus (OR = 0.2, 95% CI = 0.05, 0.7) over time.
Conclusions: This study supports teledermatology as a feasible and effective option for providing follow-up care for atopic dermatitis patients of various demographic standings.
背景:近年来,远程皮肤病学作为一种医疗服务方式迅速崛起,对特应性皮炎(AD)等慢性炎症性皮肤病的治疗具有潜在意义:本研究通过比较虚拟医疗与传统诊室就诊,评估远程医疗在特应性皮炎治疗中的效用,旨在确定这两种医疗服务模式在临床效果上的差异:从两家皮肤科诊所招募各年龄段的 AD 患者。符合纳入标准的连续就诊患者被邀请参加研究。同意参与研究的患者被随机分配到虚拟或面对面研究组,并有机会拒绝接受任何一个研究组的治疗。纳入标准要求参与者确诊为注意力缺失症。排除标准包括可能影响治疗过程的严重并发症、无法进行远程会诊(如没有用于视频会议的摄像头)以及自行宣布的操作 Zoom 的限制。患者在基线(第 0 周)、4 至 6 周和 8 至 12 周时接受了 6 项疗效参数的评估:结果:在虚拟组中,所有 6 项皮肤测量结果均显示疗效有所改善。平均体表面积得分在随访期间有所下降(β = -.07,95% CI = -0.1,-0.3)。随着时间的推移,虚拟医疗患者出现中度至重度未控制疾病(OR = 0.2; 95% CI = 0.06, 0.5)和瘙痒症(OR = 0.2, 95% CI = 0.05, 0.7)的几率降低了 80%:本研究支持远程皮肤病学作为一种可行且有效的选择,为不同人群的特应性皮炎患者提供后续护理。
{"title":"Teledermatology Versus In-Person Visits for the Follow-Up of Atopic Dermatitis Patients.","authors":"Oluwatosin Odeshi, Tarek Turk, Loretta Fiorillo, Samuel Lowe, Marlene Dytoc","doi":"10.1177/12034754241253192","DOIUrl":"10.1177/12034754241253192","url":null,"abstract":"<p><strong>Background: </strong>In recent years, teledermatology has rapidly emerged as a healthcare delivery method with potential implications for managing chronic inflammatory dermatoses like atopic dermatitis (AD).</p><p><strong>Objectives: </strong>This study assesses the utility of telemedicine in the management of AD by comparing virtual care with traditional in-office visits with the aim of identifying differences in clinical outcomes between these 2 healthcare delivery modalities.</p><p><strong>Methods: </strong>Patients of all ages with AD were recruited from 2 dermatology practices. Consecutive patients presenting to the clinics who met the inclusion criteria were invited to enrol in the study. Those who consented to participate were randomly assigned to the virtual or in-person arm of the study, with the opportunity to decline care in either study arm. The inclusion criteria required participants to have a confirmed diagnosis of AD. Exclusion criteria included significant comorbidity that might affect the course of treatment, inaccessibility to teleconsults such as not having a camera for video conferences, and self-declared limitations in operating Zoom. Patients were assessed at baseline (week 0), 4 to 6 weeks, and 8 to 12 weeks using 6 efficacy parameters.</p><p><strong>Results: </strong>In the virtual group, all 6 dermatological measures suggested improved outcomes. Average Body Surface Area scores decreased (β = -.07, 95% CI = -0.1, -0.3) over the course of follow-up. Virtual care patients had 80% lower odds of moderate-to-severe uncontrolled disease (OR = 0.2; 95% CI = 0.06, 0.5) and pruritus (OR = 0.2, 95% CI = 0.05, 0.7) over time.</p><p><strong>Conclusions: </strong>This study supports teledermatology as a feasible and effective option for providing follow-up care for atopic dermatitis patients of various demographic standings.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-03-06DOI: 10.1177/12034754241235967
Varniraj Patel, Athira Sathyan
{"title":"Cydnidae Pigmentation.","authors":"Varniraj Patel, Athira Sathyan","doi":"10.1177/12034754241235967","DOIUrl":"10.1177/12034754241235967","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140039515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Ocular rosacea is an underdiagnosed form of rosacea that may occur with or without typical cutaneous signs of rosacea. One of the common manifestations is dry eyes. Although the use of intense pulsed light (IPL) in the treatment of rosacea-related dry eyes has been reported, a recent review is lacking.
Methods: A scoping review was performed to summarize the efficacy of IPL in the treatment of ocular rosacea.
Results: Five articles were included, representing 108 patients, with a mean age of 58.4 years. Based on available data, 59.2% (n = 58/98) were female. The studies detailed the use of IPL in combination with meibomian gland expression treatment. Overall, 91% (n = 89/98) of patients with ocular rosacea treated with IPL had a partial response and 9% (n = 9/98) had no response. IPL therapy did not lead to complete recovery in any of the included patients. One participant experienced an adverse event across the included studies.
Conclusions: IPL is a promising treatment modality for ocular rosacea, as demonstrated by its ability to relieve dry eye symptoms with limited adverse events. Further research into this novel treatment is necessary to ascertain its role in the management of ocular rosacea.
{"title":"A Review of Intense Pulsed Light in the Treatment of Ocular Rosacea.","authors":"Mahek Shergill, Sophie Khaslavsky, Shani Avraham, Nadia Kashetsky, Kirill Zaslavsky, Ilya Mukovozov","doi":"10.1177/12034754241254051","DOIUrl":"10.1177/12034754241254051","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular rosacea is an underdiagnosed form of rosacea that may occur with or without typical cutaneous signs of rosacea. One of the common manifestations is dry eyes. Although the use of intense pulsed light (IPL) in the treatment of rosacea-related dry eyes has been reported, a recent review is lacking.</p><p><strong>Methods: </strong>A scoping review was performed to summarize the efficacy of IPL in the treatment of ocular rosacea.</p><p><strong>Results: </strong>Five articles were included, representing 108 patients, with a mean age of 58.4 years. Based on available data, 59.2% (n = 58/98) were female. The studies detailed the use of IPL in combination with meibomian gland expression treatment. Overall, 91% (n = 89/98) of patients with ocular rosacea treated with IPL had a partial response and 9% (n = 9/98) had no response. IPL therapy did not lead to complete recovery in any of the included patients. One participant experienced an adverse event across the included studies.</p><p><strong>Conclusions: </strong>IPL is a promising treatment modality for ocular rosacea, as demonstrated by its ability to relieve dry eye symptoms with limited adverse events. Further research into this novel treatment is necessary to ascertain its role in the management of ocular rosacea.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-07DOI: 10.1177/12034754231225958
Yin Yu, Lin Feng
{"title":"Squamous Cell Carcinoma Arising From Discoid Lupus Erythematosus.","authors":"Yin Yu, Lin Feng","doi":"10.1177/12034754231225958","DOIUrl":"10.1177/12034754231225958","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-16DOI: 10.1177/12034754241227801
Shubham Kumar, Saurabh Singh
{"title":"Unilateral Neonatal Milia.","authors":"Shubham Kumar, Saurabh Singh","doi":"10.1177/12034754241227801","DOIUrl":"10.1177/12034754241227801","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139741178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-03-11DOI: 10.1177/12034754241239250
Ahmed Bagit, Muskaan Sachdeva, Siddhartha Sood, Edgar Akuffo-Addo, Sauliha Alli, Khalad Maliyar, Jorge R Georgakopoulos, Asfandyar Mufti, Jensen Yeung
{"title":"Onset of Vitiligo Within Patients Receiving Immune Checkpoint Inhibitors: An Evidence-Based Review.","authors":"Ahmed Bagit, Muskaan Sachdeva, Siddhartha Sood, Edgar Akuffo-Addo, Sauliha Alli, Khalad Maliyar, Jorge R Georgakopoulos, Asfandyar Mufti, Jensen Yeung","doi":"10.1177/12034754241239250","DOIUrl":"10.1177/12034754241239250","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-06DOI: 10.1177/12034754241252439
Kaylin Bechard, Eunice Chow
{"title":"Acroangiodermatitis of Mali.","authors":"Kaylin Bechard, Eunice Chow","doi":"10.1177/12034754241252439","DOIUrl":"10.1177/12034754241252439","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-05DOI: 10.1177/12034754241230689
Ekaterina R Dunaeva, Evgenia S Pyatigorets
{"title":"Angiolymphoid With Eosinophilia.","authors":"Ekaterina R Dunaeva, Evgenia S Pyatigorets","doi":"10.1177/12034754241230689","DOIUrl":"10.1177/12034754241230689","url":null,"abstract":"","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}