Background: Psoriasis is a very common skin condition that is caused by an immune system problem. T-cells, dendritic cells, macrophages and neutrophils all play a role in the proliferation of keratinocytes. Several genetic and environmental factors are involved in the development of this condition. Objectives: The purpose of this study is to review aetiopathogenic causes and therapeutic aspects of psoriasis. Therefore, the literature review aims to address the following: Explore psoriasis theories and factors that influence psoriasis. Review of effectiveness of different treatment methods in the management of mild, moderate and severe psoriasis. In addition, there is a need to identify and evaluate new or novel therapies in the treatment of moderate and severe forms of psoriasis. Methods: A narrative literature review provides an overview of the extensive literature on the etiology, pathogenesis and treatment of psoriasis. The data comes from well reads articles published over the last 30 years (1992-2022). Electronic databases were taken from Google Scholar, PubMed, Medscape and the University of South Wales. Results: Two hundred two articles, which varied between literature reviews, systematic reviews, review articles, randomized controlled studies, meta-analyses and comparative studies. 100 out of 202 of the articles in this thesis focused on discussing the etiology, pathogenesis, pathophysiology and psoriasis treatments. Conclusion: Psoriasis is a multifactorial chronic disease. Genetics, immune and environmental factors play a significant role in its development. Psoriasis is a treatable but incurable disease that is widespread and has a significant impact on quality of life. Advances in understanding the etiology and pathogenesis of psoriasis will undoubtedly lead to the discovery of new treatments and better patient outcomes and improve quality of life for patients.
{"title":"Update Aetiopathogenesis and Treatment of Psoriasis: A Literature Review","authors":"Saad R. Abed","doi":"10.46889/jdr.2023.4201","DOIUrl":"https://doi.org/10.46889/jdr.2023.4201","url":null,"abstract":"Background: Psoriasis is a very common skin condition that is caused by an immune system problem. T-cells, dendritic cells, macrophages and neutrophils all play a role in the proliferation of keratinocytes. Several genetic and environmental factors are involved in the development of this condition.\u0000\u0000Objectives: The purpose of this study is to review aetiopathogenic causes and therapeutic aspects of psoriasis. Therefore, the literature review aims to address the following:\u0000\u0000Explore psoriasis theories and factors that influence psoriasis.\u0000Review of effectiveness of different treatment methods in the management of mild, moderate and severe psoriasis.\u0000In addition, there is a need to identify and evaluate new or novel therapies in the treatment of moderate and severe forms of psoriasis.\u0000Methods: A narrative literature review provides an overview of the extensive literature on the etiology, pathogenesis and treatment of psoriasis. The data comes from well reads articles published over the last 30 years (1992-2022). Electronic databases were taken from Google Scholar, PubMed, Medscape and the University of South Wales.\u0000\u0000Results: Two hundred two articles, which varied between literature reviews, systematic reviews, review articles, randomized controlled studies, meta-analyses and comparative studies. 100 out of 202 of the articles in this thesis focused on discussing the etiology, pathogenesis, pathophysiology and psoriasis treatments.\u0000\u0000Conclusion: Psoriasis is a multifactorial chronic disease. Genetics, immune and environmental factors play a significant role in its development. Psoriasis is a treatable but incurable disease that is widespread and has a significant impact on quality of life. Advances in understanding the etiology and pathogenesis of psoriasis will undoubtedly lead to the discovery of new treatments and better patient outcomes and improve quality of life for patients.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73854331","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}
Background: The Affordable Care Act (ACA) was intended, in part, to reduce the uninsured population. It underwent full implementation in 2014 with optional state Medicaid expansion and health insurance marketplaces. Prior to the ACA, studies show that insurance status affects cancer care, including prevention, diagnosis, stage at diagnosis, and management. ACA impact on malignant melanoma is unknown. In this study, the primary objective is to examine the impact of the ACA on insurance rates among patients diagnosed with malignant melanoma. Survival by insurance type was also assessed. Methods: A retrospective analysis of the Surveillance, Epidemiology and End Results (SEER) cancer registry was performed for malignant melanoma between 2007 (first year of insurance da-ta in SEER) and 2015. Standardized mean differences were used for 2007-2013 and 2014-2015 (after full ACA implementation) for the primary objective. Sub-analysis was performed for Med-icaid expansion and non-expansion states. The impact of insurance type (uninsured, Medicaid, non-Medicaid) on all-cause and cause-specific mortality was assessed via adjusted cox regression models. Results: Nationally, the ACA decreased percentage of uninsured patients (-1.12% to -2.26%, P<0.05) and increased percentage of Medicaid enrollees (+1.53% to +4.02%, P<.005) diagnosed with malignant melanoma. Expansion states showed decreased percentage of uninsured patients (-1.43% to -2.24%, P<0.05) and increased percentage of Medicaid enrollees (+1.66% to +4.84%, P<0.05). Non-expansion states showed no change in percentages of uninsured patients and Medicaid enrollees. All-cause and cause-specific mortality were decreased in uninsured and Medicaid patients diagnosed with malignant melanoma compared to non-Medicaid insured patients (reference group). Discussion: The ACA decreased the rate of patients diagnosed with malignant melanoma with uninsured status, but this was only significant in Medicaid expansion states. Although diagnosis of melanoma is associated with High Socioeconomic Status (SES), Medicaid expansion seems to have increased access to dermatologic care. Increasing the number of states expanding Medicaid may be beneficial. However, Medicaid patient have worse all-cause and cause-specific mortality compared to non-Medicaid insured patients. Addressing these disparities through policy is important to ensure insurance coverage translates to better outcomes.
{"title":"Insurance Trends in Patients Diagnosed with Melanoma Before and After the Affordable Care Act: A National Database Study","authors":"V. Ramachandran","doi":"10.46889/jdr.2023.4109","DOIUrl":"https://doi.org/10.46889/jdr.2023.4109","url":null,"abstract":"Background: The Affordable Care Act (ACA) was intended, in part, to reduce the uninsured population. It underwent full implementation in 2014 with optional state Medicaid expansion and health insurance marketplaces. Prior to the ACA, studies show that insurance status affects cancer care, including prevention, diagnosis, stage at diagnosis, and management. ACA impact on malignant melanoma is unknown. In this study, the primary objective is to examine the impact of the ACA on insurance rates among patients diagnosed with malignant melanoma. Survival by insurance type was also assessed.\u0000\u0000Methods: A retrospective analysis of the Surveillance, Epidemiology and End Results (SEER) cancer registry was performed for malignant melanoma between 2007 (first year of insurance da-ta in SEER) and 2015. Standardized mean differences were used for 2007-2013 and 2014-2015 (after full ACA implementation) for the primary objective. Sub-analysis was performed for Med-icaid expansion and non-expansion states. The impact of insurance type (uninsured, Medicaid, non-Medicaid) on all-cause and cause-specific mortality was assessed via adjusted cox regression models.\u0000\u0000Results: Nationally, the ACA decreased percentage of uninsured patients (-1.12% to -2.26%, P<0.05) and increased percentage of Medicaid enrollees (+1.53% to +4.02%, P<.005) diagnosed with malignant melanoma. Expansion states showed decreased percentage of uninsured patients (-1.43% to -2.24%, P<0.05) and increased percentage of Medicaid enrollees (+1.66% to +4.84%, P<0.05). Non-expansion states showed no change in percentages of uninsured patients and Medicaid enrollees. All-cause and cause-specific mortality were decreased in uninsured and Medicaid patients diagnosed with malignant melanoma compared to non-Medicaid insured patients (reference group).\u0000\u0000Discussion: The ACA decreased the rate of patients diagnosed with malignant melanoma with uninsured status, but this was only significant in Medicaid expansion states. Although diagnosis of melanoma is associated with High Socioeconomic Status (SES), Medicaid expansion seems to have increased access to dermatologic care. Increasing the number of states expanding Medicaid may be beneficial. However, Medicaid patient have worse all-cause and cause-specific mortality compared to non-Medicaid insured patients. Addressing these disparities through policy is important to ensure insurance coverage translates to better outcomes.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75545492","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}
Melanocytes respond to trauma or cutaneous inflammation by producing varying amounts of melanin, which manifests as either hyperpigmentation or hypopigmentation. Post inflammatory Hypopigmentation (PIH) is an acquired partial or total loss of skin pigmentation that occurs after cutaneous inflammation or injury [1]. Mechanisms and pathogenesis of PIH remain unclear. It is difficult to understand how individuals respond to inflammation differently. Skin discoloration is the primary clinical indication of pigment incontinence [2]. Vitiligo, another disease that presents similarly, is often confused with PIH. Significant contrast in wood light and dermoscopy can lead to a positive diagnosis of vitiligo.
{"title":"Vulvar Lesion Mimicking Vitiligo Revealing a Squamous Cell Carcinoma","authors":"Imane Kacimi Alaoui","doi":"10.46889/jdr.2023.4108","DOIUrl":"https://doi.org/10.46889/jdr.2023.4108","url":null,"abstract":"Melanocytes respond to trauma or cutaneous inflammation by producing varying amounts of melanin, which manifests as either hyperpigmentation or hypopigmentation. Post inflammatory Hypopigmentation (PIH) is an acquired partial or total loss of skin pigmentation that occurs after cutaneous inflammation or injury [1]. Mechanisms and pathogenesis of PIH remain unclear. It is difficult to understand how individuals respond to inflammation differently. Skin discoloration is the primary clinical indication of pigment incontinence [2]. Vitiligo, another disease that presents similarly, is often confused with PIH. Significant contrast in wood light and dermoscopy can lead to a positive diagnosis of vitiligo.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85277750","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}
Melanoma can be deadly if not detected and treated early. The association of race with survival in cutaneous malignancies has been researched previously and it has been noted that Hispanic patients have worse melanoma-specific survival compared to non-Hispanic white patients [1]. While research has shown that Hispanic race can be a factor in melanoma survival rates, the specific impact of Hispanic subpopulations on melanoma outcomes is not well understood. In recent years, the Hispanic population in the United States has grown rapidly and is expected to continue to do so in the coming decades. These populations represent diverse individuals from various countries of origins, ethnic backgrounds, and differing cultures. In fact, the Hispanic nomenclature includes diverse worldwide subpopulations and clinical investigations often focus on the ethnic group, resulting in an incomplete characterization of skin malignancies and survival among distinct Latino groups. It is important to understand the unique melanoma survival patterns among different Hispanic subpopulations as these populations are heterogenous.
{"title":"Differences in Melanoma Survival in Hispanic Subpopulations","authors":"V. Ramachandran","doi":"10.46889/jdr.2023.4106","DOIUrl":"https://doi.org/10.46889/jdr.2023.4106","url":null,"abstract":"Melanoma can be deadly if not detected and treated early. The association of race with survival in cutaneous malignancies has been researched previously and it has been noted that Hispanic patients have worse melanoma-specific survival compared to non-Hispanic white patients [1]. While research has shown that Hispanic race can be a factor in melanoma survival rates, the specific impact of Hispanic subpopulations on melanoma outcomes is not well understood. In recent years, the Hispanic population in the United States has grown rapidly and is expected to continue to do so in the coming decades. These populations represent diverse individuals from various countries of origins, ethnic backgrounds, and differing cultures. In fact, the Hispanic nomenclature includes diverse worldwide subpopulations and clinical investigations often focus on the ethnic group, resulting in an incomplete characterization of skin malignancies and survival among distinct Latino groups. It is important to understand the unique melanoma survival patterns among different Hispanic subpopulations as these populations are heterogenous.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80839331","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}
The importance of regaining the eccrine function by removing all possible blockages occurring over the skin during Psoriasis as a result of continuous deposition of desquamated cornfield cells require a medicated cleanser with selective targeting of deformed horny cells. Present study details about JRK’s Psorolin derma skin care soap normalizing eccrine function, removing all deformed horny cells and also resulting in greater porosity of skin to the subsequent treatment through well-structured scientific experiment. We have employed Eosin and Nile red uptake assay on tape strips, urease-GLDH assay and localized eccrine quantification in response to intradermal Methacholine chloride. Findings clearly show JRK’s Psorolin derma skin care soap met all the necessary pre-requisites to be the best candidate cleanser for psoriasis patients, details are discussed in the article.
{"title":"Selective Eviction of Deformed Horny Cells by JRK’s Psorolin Derma Skin Care Soap","authors":"Amruthavalli Gv","doi":"10.46889/jdr.2023.4105","DOIUrl":"https://doi.org/10.46889/jdr.2023.4105","url":null,"abstract":"The importance of regaining the eccrine function by removing all possible blockages occurring over the skin during Psoriasis as a result of continuous deposition of desquamated cornfield cells require a medicated cleanser with selective targeting of deformed horny cells. Present study details about JRK’s Psorolin derma skin care soap normalizing eccrine function, removing all deformed horny cells and also resulting in greater porosity of skin to the subsequent treatment through well-structured scientific experiment. We have employed Eosin and Nile red uptake assay on tape strips, urease-GLDH assay and localized eccrine quantification in response to intradermal Methacholine chloride. Findings clearly show JRK’s Psorolin derma skin care soap met all the necessary pre-requisites to be the best candidate cleanser for psoriasis patients, details are discussed in the article.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81142601","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}
Terbinafine is a commonly used anti-fungal agent in dermatological practice but not one clearly associated with erythema nodosum. There is only one published report in 2014 that described a delayed onset of erythema nodosum after cholestasis complicated terbinafine therapy. We report the case of a woman who developed erythema nodosum whilst on terbinafine therapy for onychomycosis to further consider this link and its potential implications.
{"title":"Erythema Nodosum Associated with Terbinafine Therapy- A Case Report","authors":"Raghu Vasanthan","doi":"10.46889/jdr.2023.4104","DOIUrl":"https://doi.org/10.46889/jdr.2023.4104","url":null,"abstract":"Terbinafine is a commonly used anti-fungal agent in dermatological practice but not one clearly associated with erythema nodosum. There is only one published report in 2014 that described a delayed onset of erythema nodosum after cholestasis complicated terbinafine therapy. We report the case of a woman who developed erythema nodosum whilst on terbinafine therapy for onychomycosis to further consider this link and its potential implications.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90327422","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}
Recent interest in AI had been driven by an evolution in machine learning resulting in the arrival of ‘deep learning.’ Given sufficient dataset size and processing power, deep learning utilizes Convolutional Neural Networks (CNNs). Deep learning technique is basically the modernized extended version of classical neural networks. The current neural network that is used is more superior in terms of the classical neural network as the current deep learning neural networks had multiple layers [2]. The deep learning method tends to deal with more complex and non-linear data. The deep learning in comparison with the classical neural networks can handle the larger volume and wide complex of data. As it learns directly from the dataset without human direction, deep learning is able to account for inter-data variability as well as process unstandardized data. AI algorithms have been currently used in the diagnosis of diabetic retinopathy, congenital cataracts, melanoma, and onychomycosis [3]. Outside clinical care, AI is being employed to support and potentially replace the roles of healthcare managers in resource, staffing, and financial management.
{"title":"Smartphone-Assisted Artificial Intelligence in Dermatology- A Novel Approach to Help General Practitioners in Underserved Areas","authors":"Sandesh Shah","doi":"10.46889/jdr.2023.4103","DOIUrl":"https://doi.org/10.46889/jdr.2023.4103","url":null,"abstract":"Recent interest in AI had been driven by an evolution in machine learning resulting in the arrival of ‘deep learning.’ Given sufficient dataset size and processing power, deep learning utilizes Convolutional Neural Networks (CNNs). Deep learning technique is basically the modernized extended version of classical neural networks. The current neural network that is used is more superior in terms of the classical neural network as the current deep learning neural networks had multiple layers [2]. The deep learning method tends to deal with more complex and non-linear data. The deep learning in comparison with the classical neural networks can handle the larger volume and wide complex of data. As it learns directly from the dataset without human direction, deep learning is able to account for inter-data variability as well as process unstandardized data. AI algorithms have been currently used in the diagnosis of diabetic retinopathy, congenital cataracts, melanoma, and onychomycosis [3]. Outside clinical care, AI is being employed to support and potentially replace the roles of healthcare managers in resource, staffing, and financial management.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88178872","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}
Dear Editor, we report a case of a 67-year-old male patient who was first diagnosed with tumor-stage Mycosis Fungoides (MF) (T3N0M0B0a, clinical stage IIB – current ISCL/EORTC classification) in 2017. During the course of the disease of MF the patient was treated with bexarotene, gemcitabine and chlorambucil. All these treatments helped only short-term, quickly followed by relapses of the skin lesions. In September 2018, the patient developed a rapidly progressive disease with erythematous patches, plaques and ulcerated tumors (mSWAT 20) (Fig. 1). CD30 expression was determined in several skin biopsies, each with an expression rate of 2-5% (Fig. 1). Despite this relatively low amount, the tumor board decision was made favoring the monoclonal CD30-antibody Brentuximab-Vedotin (BV) application. In October 2018, BV was first administered with the maximum dose of 180 mg (1.8mg/kg of body weight). Five days after the infusion, the patient developed abdominal pain, diarrhea, chills and fever. Blood cultures were positive for Methicillin-Resistant Staphylococcus Aureus (MRSA) and a MRSA-sepsis was diagnosed. Intensive medical care was requiredand under symptomatic treatment, the patient recovered completely. Two months later – in December 2018 – the patient presented again in our department to evaluate the skin lesions, displaying a partial response (mSWAT 12) (Fig. 1). At this time, the sepsis was not considered in direct context with the medication. The patient had several ulcerations and had been a known MRSA-patient already before the initiation of the treatment. Therefore, the patient received BV for a second time in the total dose of 180 mg. Nine days after the infusion, abdominal pain with vomiting, diarrhea and unconsciousness occurred. The patient was readmitted to the intensive care unit and an acute pancreatitis was diagnosed (lipase 1502 U/l). Under symptomatic therapy and close monitoring, pancreatitis resolved within two weeks. BV is a CD30 antibody-drug conjugate. The cytotoxic component is monomethylauristatin E, a potent inhibitor of microtubule assembly [1]. It is approved for the treatment of patients with relapsed or refractory Hodgkin’s Lymphoma (HL), systemic Anaplastic Large-T-cell Lymphoma (sALCL) and in addition, for the treatment of CD30-positive Cutaneous T-cell Lymphoma (CTCL) [2]. This case report describes two serious complications after the administration of BV in the same patient. Both belong in the spectrum of rare to infrequent side effects. Awareness of the possibility of pancreatitis as a side effect of BV is essential, especially because it seems to occur not immediately but within days or weeks after the treatment application. The literature describes pancreatitis in patients with HL, ALCL and cutaneous Gamma Delta T-cell Lymphoma (GD-TCL) [3]. The onset of pancreatitis in most cases seems to be delayed with a range of 7-33 days [1,4]. In our patient the first symptoms presented nine days after the BV-administration
{"title":"Sepsis and Acute Pancreatitis in Tumor-Stage Mycosis Fungoides and Treatment with Brentuximab-Vedotin","authors":"M. Jost","doi":"10.46889/jdr.2023.4102","DOIUrl":"https://doi.org/10.46889/jdr.2023.4102","url":null,"abstract":"Dear Editor, we report a case of a 67-year-old male patient who was first diagnosed with tumor-stage Mycosis Fungoides (MF) (T3N0M0B0a, clinical stage IIB – current ISCL/EORTC classification) in 2017. During the course of the disease of MF the patient was treated with bexarotene, gemcitabine and chlorambucil. All these treatments helped only short-term, quickly followed by relapses of the skin lesions. In September 2018, the patient developed a rapidly progressive disease with erythematous patches, plaques and ulcerated tumors (mSWAT 20) (Fig. 1). CD30 expression was determined in several skin biopsies, each with an expression rate of 2-5% (Fig. 1). Despite this relatively low amount, the tumor board decision was made favoring the monoclonal CD30-antibody Brentuximab-Vedotin (BV) application. In October 2018, BV was first administered with the maximum dose of 180 mg (1.8mg/kg of body weight). Five days after the infusion, the patient developed abdominal pain, diarrhea, chills and fever. Blood cultures were positive for Methicillin-Resistant Staphylococcus Aureus (MRSA) and a MRSA-sepsis was diagnosed. Intensive medical care was requiredand under symptomatic treatment, the patient recovered completely. Two months later – in December 2018 – the patient presented again in our department to evaluate the skin lesions, displaying a partial response (mSWAT 12) (Fig. 1). At this time, the sepsis was not considered in direct context with the medication. The patient had several ulcerations and had been a known MRSA-patient already before the initiation of the treatment. Therefore, the patient received BV for a second time in the total dose of 180 mg. Nine days after the infusion, abdominal pain with vomiting, diarrhea and unconsciousness occurred. The patient was readmitted to the intensive care unit and an acute pancreatitis was diagnosed (lipase 1502 U/l). Under symptomatic therapy and close monitoring, pancreatitis resolved within two weeks. BV is a CD30 antibody-drug conjugate. The cytotoxic component is monomethylauristatin E, a potent inhibitor of microtubule assembly [1]. It is approved for the treatment of patients with relapsed or refractory Hodgkin’s Lymphoma (HL), systemic Anaplastic Large-T-cell Lymphoma (sALCL) and in addition, for the treatment of CD30-positive Cutaneous T-cell Lymphoma (CTCL) [2]. This case report describes two serious complications after the administration of BV in the same patient. Both belong in the spectrum of rare to infrequent side effects. Awareness of the possibility of pancreatitis as a side effect of BV is essential, especially because it seems to occur not immediately but within days or weeks after the treatment application. The literature describes pancreatitis in patients with HL, ALCL and cutaneous Gamma Delta T-cell Lymphoma (GD-TCL) [3]. The onset of pancreatitis in most cases seems to be delayed with a range of 7-33 days [1,4]. In our patient the first symptoms presented nine days after the BV-administration","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74356017","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}
A 46-year-old male patient came to our outpatient clinic in 2019 with nodules on the whole body, which first developed three years ago. He complained about severe pruritus (Fig. 1). His medical history included Parkinson’s disease and schizophrenia. The only systemic medication he took was Trihexyphenidyl, an anticholinergic drug. For topical treatment, he used different ointments with glucocorticosteroids. Skin examination revealed erythematous, hyperkeratotic plaques and nodules on the whole body with accentuation on the limbs. Genitals and mucous membranes were free. Histopathology proved the diagnosis of nodular prurigo. Differential diagnoses included lichen planus verrucosus and multiple eruptive keratoacanthomas. The patient received intravenous Naloxone twice for two to three days. Psychiatric therapy was recommended. Unfortunately, the patient didn’t present himself to our clinic again. Other therapy options are intraleasional triamcinolone, PUVA, ciclosporin, thalidomide, pregabalin or dupilumab.
{"title":"Just an Itch?","authors":"M. Jost","doi":"10.46889/jdr.2023.4101","DOIUrl":"https://doi.org/10.46889/jdr.2023.4101","url":null,"abstract":"A 46-year-old male patient came to our outpatient clinic in 2019 with nodules on the whole body, which first developed three years ago. He complained about severe pruritus (Fig. 1).\u0000\u0000His medical history included Parkinson’s disease and schizophrenia. The only systemic medication he took was Trihexyphenidyl, an anticholinergic drug.\u0000\u0000For topical treatment, he used different ointments with glucocorticosteroids. Skin examination revealed erythematous, hyperkeratotic plaques and nodules on the whole body with accentuation on the limbs. Genitals and mucous membranes were free.\u0000\u0000Histopathology proved the diagnosis of nodular prurigo. Differential diagnoses included lichen planus verrucosus and multiple eruptive keratoacanthomas.\u0000\u0000The patient received intravenous Naloxone twice for two to three days. Psychiatric therapy was recommended. Unfortunately, the patient didn’t present himself to our clinic again. Other therapy options are intraleasional triamcinolone, PUVA, ciclosporin, thalidomide, pregabalin or dupilumab.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88787440","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}
I. Couissi, H. Baybay, Sara El Loudi, Z. Douhi, Meryem Soughi, F. Zahra Mernissi
Background: The objective of our study is to describe the different nail involvement at the beginning of the disease according to the type of pemphigus and according to the severity of the pemphigus. Material and methods: We carried out a prospective study over a 3-year period from 2019 to 2022 that included 21 hospitalized patients out of 80 with polydactyly nail involvement 13 pemphigus vulgaris, 4 pemphigus vegetans, and 3 superficial pemphigus in our dermatology department Centre Hospitalier Universitaire (CHU) Hassan II Fez. Results: Paronychia was the most frequent finding overall, observed in 11 (52.38%) cases, followed by onychomadesis and Beau's lines in 8 cases (38%) and subungual hemorrhage in 6 cases (28.57%). Nail involvement was correlated with the severity of the pemphigus, in particular with severe mucosal involvement (17 patients or 80.9%). Conclusion: Nail involvement is a sign of pemphigus severity and may herald an exacerbation of the underlying disease.
{"title":"Nail Involvement in Pemphigus: Brief Report","authors":"I. Couissi, H. Baybay, Sara El Loudi, Z. Douhi, Meryem Soughi, F. Zahra Mernissi","doi":"10.46889/jdr.2023.4209","DOIUrl":"https://doi.org/10.46889/jdr.2023.4209","url":null,"abstract":"Background: The objective of our study is to describe the different nail involvement at the beginning of the disease according to the type of pemphigus and according to the severity of the pemphigus. Material and methods: We carried out a prospective study over a 3-year period from 2019 to 2022 that included 21 hospitalized patients out of 80 with polydactyly nail involvement 13 pemphigus vulgaris, 4 pemphigus vegetans, and 3 superficial pemphigus in our dermatology department Centre Hospitalier Universitaire (CHU) Hassan II Fez. Results: Paronychia was the most frequent finding overall, observed in 11 (52.38%) cases, followed by onychomadesis and Beau's lines in 8 cases (38%) and subungual hemorrhage in 6 cases (28.57%). Nail involvement was correlated with the severity of the pemphigus, in particular with severe mucosal involvement (17 patients or 80.9%). Conclusion: Nail involvement is a sign of pemphigus severity and may herald an exacerbation of the underlying disease.","PeriodicalId":15448,"journal":{"name":"Journal of clinical & experimental dermatology research","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84918050","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}
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