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Utilization of Topical Ruxolitinib in Dermatology: A Review. 外用Ruxolitinib在皮肤病学中的应用综述。
Q1 Medicine Pub Date : 2023-05-01
Nadia Kashetsky, Irina Turchin

As systemic administration of Janus kinase-inhibitors is associated with safety concerns, local alternatives, such as topical ruxolitinib, have been developed. This review summarizes utilization of topical ruxolitinib in dermatology. A literature search was performed of studies reporting topical use of ruxolitinib in dermatologic conditions. Twenty-four articles were included, representing 2618 patients. Results show improvement with topical ruxolitinib formulations in atopic dermatitis, vitiligo, psoriasis, and lichen planus. Results are conflicting in alopecia areata. Minimal bioavailability and low rates of mild-to-moderate treatment-related adverse events support a favorable safety profile and higher tolerability of topical ruxolitinib compared to oral Janus kinase-inhibitors.

由于全身给药Janus激酶抑制剂与安全性问题有关,局部替代品,如局部鲁索利替尼,已经开发出来。本文综述了鲁索利替尼外用在皮肤病学中的应用。对报道局部使用鲁索利替尼治疗皮肤病的研究进行了文献检索。纳入24篇文章,代表2618例患者。结果显示,局部ruxolitinib制剂改善特应性皮炎,白癜风,牛皮癣和扁平苔藓。斑秃的结果是相互矛盾的。与口服Janus激酶抑制剂相比,最小的生物利用度和较低的轻度至中度治疗相关不良事件发生率支持外用ruxolitinib有利的安全性和更高的耐受性。
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引用次数: 0
The Evolving Story of JAK Inhibitors for Treating Alopecia Areata: A Review of Current Progress and Future Directions. JAK抑制剂治疗斑秃的发展历程:综述当前进展和未来发展方向。
Q1 Medicine Pub Date : 2023-05-01
Jeff Donovan

Oral Janus kinase (JAK) inhibitors now have a position as first-line agents for treating advanced alopecia areata. Oral JAK inhibitors are considerably more effective than topical JAK inhibitors, although topical agents may still have a valuable role for specific subgroups of patients. The US FDA approval of baricitinib in 2022 was an important milestone. Numerous JAK inhibitors are now being intensely studied for use in alopecia areata and several additional medications may also become approved in the near future. Accumulating clinical trial data points to a generally good safety profile for JAK inhibitors when used for patients with alopecia areata. However, long-term data pertaining to the safety and efficacy in this patient population are lacking.

口服Janus激酶(JAK)抑制剂现已成为治疗晚期斑秃的一线药物。口服JAK抑制剂比外用JAK抑制剂有效得多,尽管外用药物可能对特定亚组患者仍有重要作用。2022年美国FDA批准baricitinib是一个重要的里程碑。许多JAK抑制剂目前正在深入研究用于斑秃,一些额外的药物也可能在不久的将来获得批准。累积的临床试验数据表明,JAK抑制剂在治疗斑秃患者时具有良好的安全性。然而,缺乏关于该患者群体安全性和有效性的长期数据。
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引用次数: 0
Antibiotic Resistance in Dermatology Part 2: Combating Resistance. 皮肤病学抗生素耐药性第2部分:对抗耐药性。
Q1 Medicine Pub Date : 2023-03-01
Austinn C Miller, Susuana Adjei, Laurie A Temiz, Sonali Batta, Stephen K Tyring

Virtually any antibiotic can be used in dermatology given the broad range of conditions treated. With the widespread use of antibiotics and the rapid emergence of resistant organisms, it is important to understand how dermatologists can combat this issue.

几乎任何抗生素都可以用于皮肤科,因为治疗的条件范围很广。随着抗生素的广泛使用和耐药生物的迅速出现,了解皮肤科医生如何应对这一问题非常重要。
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引用次数: 0
Chlormethine Gel for the Treatment of Mycosis Fungoides (Cutaneous T-cell Lymphoma) in Canada. 氯甲基凝胶治疗蕈样真菌病(皮肤t细胞淋巴瘤)在加拿大。
Q1 Medicine Pub Date : 2023-03-01
Robert Gniadecki, Emilia Paron

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma (CTCL), representing almost 50% of all lymphomas arising in the skin. There is an unmet need in the treatment of MF in Canada, as current available therapies for early-stage MF are limited, without topical agents previously indicated. Chlormethine gel is a topical antineoplastic agent with phase II clinical trial and real-world data demonstrating safety and efficacy as a treatment option for adults with MF. Skin-related side effects such as dermatitis can be managed through appropriate strategies. The use of chlormethine gel can be considered for patients with stage IA and IB MF-CTCL as it provides an easily administered, skin-directed treatment option that fills an unmet need in Canada.

蕈样真菌病(MF)是最常见的皮肤t细胞淋巴瘤(CTCL),几乎占所有皮肤淋巴瘤的50%。加拿大在MF治疗方面的需求尚未得到满足,因为目前可用于早期MF的治疗方法有限,没有先前指示的局部药物。氯甲基凝胶是一种局部抗肿瘤药物,II期临床试验和实际数据表明,作为成人MF的治疗选择,安全性和有效性。皮肤相关的副作用,如皮炎,可以通过适当的策略加以控制。氯甲基凝胶可用于IA期和IB期MF-CTCL患者,因为它提供了一种易于管理的皮肤导向治疗选择,填补了加拿大未满足的需求。
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引用次数: 0
Tralokinumab for Moderate-to-Severe Atopic Dermatitis in Adults. 曲洛单抗治疗成人中重度特应性皮炎。
Q1 Medicine Pub Date : 2023-01-01
Abrahim Abduelmula, Brian D Rankin, Asfandyar Mufti, Jensen Yeung, Vimal H Prajapati

Atopic dermatitis (AD) is a common, chronic, recurrent, immune-mediated inflammatory skin disease. Targeted treatment options remain limited. Tralokinumab (Adtralza®) is a promising, new systemic therapy that inhibits interleukin-13. It was recently approved by Health Canada and the US FDA for the treatment of moderate-to-severe AD in adults and may be used alone or with topical corticosteroids. Herein, we review the efficacy and safety of tralokinumab in adults, as demonstrated in clinical trials.

特应性皮炎(AD)是一种常见的慢性、复发性、免疫介导的炎症性皮肤病。有针对性的治疗方案仍然有限。Tralokinumab (Adtralza®)是一种有前景的新型全身疗法,可抑制白细胞介素-13。它最近被加拿大卫生部和美国FDA批准用于成人中度至重度AD的治疗,可单独使用或与局部皮质类固醇一起使用。在此,我们回顾了临床试验证明的曲洛单抗在成人中的有效性和安全性。
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引用次数: 0
Antibiotic Resistance in Dermatology Part 1: Mechanisms of Resistance. 皮肤病学中的抗生素耐药:耐药机制。
Q1 Medicine Pub Date : 2023-01-01
Austinn C. Miller, Susuana Adjei, Laurie A. Temiz, Stephen K. Tyring

Virtually any antibiotic can be used in dermatology given the broad range of conditions treated. With the widespread use of antibiotics and the rapid emergence of resistant organisms, it is important to understand the mechanisms at play that contribute to resistance.

几乎任何抗生素都可以用于皮肤科,因为治疗的条件范围很广。随着抗生素的广泛使用和耐药生物的迅速出现,了解导致耐药的机制非常重要。
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引用次数: 0
Selective TYK2 Inhibition in the Treatment of Moderate to Severe Chronic Plaque Psoriasis 选择性抑制TYK2治疗中重度慢性斑块型银屑病
Q1 Medicine Pub Date : 2022-11-01
Melinda J Gooderham, H Chih-Ho Hong, Ivan V Litvinov

Moderate to severe chronic plaque psoriasis may be difficult to control using current therapies, which has led to development of a novel class of therapy, selective tyrosine kinase 2 (TYK2) inhibitors, to address this unmet need. Oral deucravacitinib is a first-inclass selective TYK2 inhibitor, which has shown efficacy in moderate to severe chronic plaque psoriasis from two phase III pivotal trials (POETYK PSO-1 and PSO-2), whereby response rates were significantly higher with deucravacitinib vs. placebo or apremilast for Psoriasis Area Severity Index (PASI) 75 and static Physician's Global Assessment (sPGA) 0/1. Deucravacitinib was generally well tolerated and safe compared to placebo and apremilast. Although deucravacitinib is a type of Janus kinase (JAK) inhibitor, it only blocks specific cytokine-driven responses, potentially reducing off-target effects more commonly associated with other JAK inhibitors on the market. Incidence rates of serious adverse events, such as serious infections, malignancies, thrombosis, cardiovascular events, creatinine kinase elevation, hematologic changes, and lipid profile abnormalities were absent or low.

目前的治疗方法可能难以控制中度至重度慢性斑块性银屑病,这导致了一种新型治疗方法的开发,选择性酪氨酸激酶2 (TYK2)抑制剂,以解决这一未满足的需求。口服deucravacitinib是一种一级选择性TYK2抑制剂,在两项III期关键试验(POETYK PSO-1和PSO-2)中显示出对中度至重度慢性斑块性银屑病的疗效,其中对于银屑病区域严重程度指数(PASI) 75和静态医师整体评估(sPGA) 0/1, deucravacitinib的缓解率明显高于安慰剂或阿普雷米司特。与安慰剂和阿普雷米司特相比,Deucravacitinib通常耐受性良好且安全。虽然deucravacitinib是一种Janus激酶(JAK)抑制剂,但它只能阻断特定的细胞因子驱动的反应,潜在地减少了市场上其他JAK抑制剂更常见的脱靶效应。严重不良事件,如严重感染、恶性肿瘤、血栓形成、心血管事件、肌酐激酶升高、血液学改变和血脂异常的发生率均不存在或较低。
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引用次数: 0
Acne Scars: An Update on Management 痤疮疤痕:管理的最新进展
Q1 Medicine Pub Date : 2022-11-01
Abdulhadi Jfri, Ali Alajmi, Mohammad Alazemi, Malika A Ladha

Acne vulgaris is a troubling skin disease known to have both physiologic and psychological effects on patients. Acne scars, a frequent complication, can further impact patients' quality of life. Scars result from an impairment in the healing process. Acne scars can be categorized as follows: atrophic scars (including ice pick, rolling, boxcar subtypes) and trophic (including hypertrophic and keloid scars), the latter being less common. Though various treatment approaches have been suggested, there is a lack of high-quality evidence on effective, type-specific acne scar approaches. Herein, we aim to review the current evidence for treating various acne scars.

寻常痤疮是一种令人不安的皮肤病,已知对患者有生理和心理上的影响。痤疮疤痕是一种常见的并发症,会进一步影响患者的生活质量。疤痕是愈合过程中的损伤造成的。痤疮疤痕可分为以下两类:萎缩性疤痕(包括冰锥型、滚型、箱型)和营养性疤痕(包括增生性和瘢痕疙瘩疤痕),后者较少见。虽然已经提出了各种治疗方法,但缺乏有效的、类型特异性痤疮疤痕方法的高质量证据。在此,我们的目的是回顾目前的证据治疗各种痤疮疤痕。
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引用次数: 0
Extracorporeal Photopheresis and Its Use in Clinical Dermatology in Canada 体外光术及其在加拿大临床皮肤病学中的应用
Q1 Medicine Pub Date : 2022-09-01
François Lagacé, Elena Netchiporouk, Irina Turchin, Wayne Gulliver, Jan Dutz, Mark G Kirchhof, Popradi Popradi, Robert Gniadecki, Charles Lynde, Ivan V Litvinov

Extracorporeal photopheresis (ECP) is an immunomodulatory therapy that has been used for over 35 years to treat numerous conditions. ECP was initially approved by the US FDA in 1988 for the treatment of Sézary syndrome, a leukemic form of cutaneous T-cell lymphoma (CTCL). Although CTCL remains the only FDA-approved indication, ECP has since been used off-label for numerous other conditions, including graft-versus-host disease (GvHD), systemic sclerosis, autoimmune bullous dermatoses, Crohn's disease, and prevention of solid organ transplant rejection. In Canada, ECP is mainly used to treat CTCL, acute and chronic GvHD, and in some instances systemic sclerosis. Herein, we review the current concepts regarding ECP mechanism of action, treatment considerations and protocols, and efficacy.

体外光疗(ECP)是一种免疫调节疗法,已被用于治疗多种疾病超过35年。ECP最初于1988年被美国FDA批准用于治疗ssamzary综合征,这是一种皮肤t细胞淋巴瘤(CTCL)的白血病形式。尽管CTCL仍然是fda批准的唯一适应症,但ECP已被用于许多其他疾病,包括移植物抗宿主病(GvHD)、系统性硬化症、自身免疫性大疱性皮肤病、克罗恩病和预防实体器官移植排斥反应。在加拿大,ECP主要用于治疗CTCL,急性和慢性GvHD,以及某些情况下的系统性硬化症。在此,我们回顾了目前关于ECP作用机制、治疗注意事项和方案以及疗效的概念。
{"title":"Extracorporeal Photopheresis and Its Use in Clinical Dermatology in Canada","authors":"François Lagacé,&nbsp;Elena Netchiporouk,&nbsp;Irina Turchin,&nbsp;Wayne Gulliver,&nbsp;Jan Dutz,&nbsp;Mark G Kirchhof,&nbsp;Popradi Popradi,&nbsp;Robert Gniadecki,&nbsp;Charles Lynde,&nbsp;Ivan V Litvinov","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Extracorporeal photopheresis (ECP) is an immunomodulatory therapy that has been used for over 35 years to treat numerous conditions. ECP was initially approved by the US FDA in 1988 for the treatment of Sézary syndrome, a leukemic form of cutaneous T-cell lymphoma (CTCL). Although CTCL remains the only FDA-approved indication, ECP has since been used off-label for numerous other conditions, including graft-versus-host disease (GvHD), systemic sclerosis, autoimmune bullous dermatoses, Crohn's disease, and prevention of solid organ transplant rejection. In Canada, ECP is mainly used to treat CTCL, acute and chronic GvHD, and in some instances systemic sclerosis. Herein, we review the current concepts regarding ECP mechanism of action, treatment considerations and protocols, and efficacy.</p>","PeriodicalId":21829,"journal":{"name":"Skin therapy letter","volume":"27 5","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35210368","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}
引用次数: 0
Toxic Epidermal Necrolysis: A Review of Past and Present Therapeutic Approaches 中毒性表皮坏死松解:回顾过去和现在的治疗方法
Q1 Medicine Pub Date : 2022-09-01
Neha Singh, Mariana Phillips

Toxic epidermal necrolysis (TEN) is an immune mediated, severe cutaneous adverse drug reaction characterized by epidermal detachment affecting greater than 30% body surface area. The mortality rate of TEN exceeds 20% and is usually caused by infection and respiratory compromise. Withdrawal of the causative drug, supportive care, and adjuvant therapy improve prognosis. Over the past decade, randomized controlled trials and meta-analyses have supported a role for cyclosporine, tumor necrosis factor alpha inhibitors, and combination therapy with intravenous immune globulin and corticosteroids. This review summarizes the medical management of TEN in adult patients.

中毒性表皮坏死松解(TEN)是一种免疫介导的严重皮肤药物不良反应,其特征是表皮脱离影响大于30%的体表面积。TEN的死亡率超过20%,通常由感染和呼吸系统损伤引起。停用致病性药物、支持治疗和辅助治疗可改善预后。在过去的十年中,随机对照试验和荟萃分析支持环孢素、肿瘤坏死因子α抑制剂以及静脉注射免疫球蛋白和皮质类固醇联合治疗的作用。本文综述了成人TEN患者的医疗管理。
{"title":"Toxic Epidermal Necrolysis: A Review of Past and Present Therapeutic Approaches","authors":"Neha Singh,&nbsp;Mariana Phillips","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Toxic epidermal necrolysis (TEN) is an immune mediated, severe cutaneous adverse drug reaction characterized by epidermal detachment affecting greater than 30% body surface area. The mortality rate of TEN exceeds 20% and is usually caused by infection and respiratory compromise. Withdrawal of the causative drug, supportive care, and adjuvant therapy improve prognosis. Over the past decade, randomized controlled trials and meta-analyses have supported a role for cyclosporine, tumor necrosis factor alpha inhibitors, and combination therapy with intravenous immune globulin and corticosteroids. This review summarizes the medical management of TEN in adult patients.</p>","PeriodicalId":21829,"journal":{"name":"Skin therapy letter","volume":"27 5","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35258629","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}
引用次数: 0
期刊
Skin therapy letter
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