Journal of the American Academy of Dermatology最新文献

Background: The risk of fungal infection in patients with psoriasis receiving biologics is not fully understood in clinical practice.

Objective: To assess the incidence and the risk of fungal infection onset in patients with psoriasis receiving biologics.

Methods: Retrospective cohort study of 592 psoriasis cases treated with biologics at a single center.

Results: Seventy-three (12.3%) of the 592 cases involved a fungal infection. Fungal infection occurrence was more frequently associated with the use of interleukin (IL)-17 inhibitors than of other biologics. The risk factors of fungal infection were the type of biologic agent (P = .004), age at the start of biologic therapy (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.02-1.06), and diabetes mellitus (OR: 2.40; 95% CI: 1.20-4.79).

Limitations: The present, retrospective study did not include patients who did not receive biologic therapy. Moreover, the type of biologic agent used was changed in many cases.

Conclusion: Psoriasis patients treated with IL-17 inhibitors were more likely to cause fungal infections, especially candidiasis, than other biologics. Moreover, the age at the start biologic therapy and diabetes mellitus onset were also independent risk factors of fungal infection.

Background: Moderate-to-severe atopic dermatitis (AD) greatly impacts children/caregivers.

Objective: Evaluate the impact of treatment with dupilumab on caregiver- and patient-reported AD symptoms and quality of life (QoL) in young children.

Methods: In the LIBERTY AD PRESCHOOL (randomized, placebo-controlled) study, children aged 6 months to 5 years with moderate-to-severe AD received dupilumab or placebo plus low-potency topical corticosteroids for 16 weeks. This post-hoc analysis assessed the change from baseline to week 16 in caregiver-reported outcome measures of AD symptoms (e.g., itch and sleep) and QoL of patients and their caregivers/families.

Results: Dupilumab (n = 83) vs placebo (n = 79) provided significant improvements in caregiver-reported AD symptoms and QoL. Significant improvements were seen as early as week 4 and sustained through the end of the study. Additionally, dupilumab vs placebo provided rapid and significant improvement in QoL measures for the patients' caregivers/families.

Limitations: Few patients aged <2 years; significance only reported for pre-specified endpoints; Infant's Dermatitis QoL Index severity strata adopted from Children's Dermatology Life Quality Index.

Conclusion: Dupilumab improved AD symptoms and QoL in patients and their caregivers/families.

Background: Melanoma, a significant global health concern, has shown evolving epidemiological trends. Accurate estimation of melanoma's burden is essential for public health strategies and interventions.

Objectives: This study aims to estimate the incidence, mortality, and disability-adjusted life years (DALYs) for melanoma, stratified by region, gender, and age group, from 1990 to 2021.

Methods: Using data from the Global Burden of Disease (GBD) 2021, we analyzed melanoma incidence, mortality rates, and DALYs in 204 countries from 1990 to 2021. These metrics were age-standardized and stratified by age, sex, Socio-Demographic Index (SDI), region, and country. The estimated annual percentage change (EAPC) was calculated to track temporal trends.

Results: Our study shows a substantial global increase in melanoma incidence, with significant disparities between genders and age groups. Higher SDI regions had increased incidence rates, while global mortality declined, likely due to improved detection and treatment.

Limitations: The reliance on estimates and models may introduce bias due to variability in disease definitions, diagnostic criteria, and data collection methods.

Conclusion: This study underscores the dynamic nature of melanoma's burden and the need for targeted, age-specific, and gender-specific interventions. Continued research is essential to address the growing challenges posed by melanoma.