Skinmed最新文献

A 16-year-old girl born from a nonconsanguineous marriage presented to the dermatology out-patient department with innumerable hyperpigmented macules predominantly over the photoexposed parts of her body involving the face, neck, chest, back, of forearms, hands, and legs with a history of photosensitivity and photophobia (Figure 1). These were interspersed with multiple depigmented macules over her arms and legs since, she was three years old. She also had a small pigmented mass involving the left eye present for the last 3 months. She had a family history of similar cutaneous lesions in her elder sister. There was no history of hearing loss, seizures, spasticity, or cognitive impairment.

For the twenty-year period from 2001 to 2021, only one new topical molecular entity for an inflammatory skin disease was approved in the United States. This situation has shifted dramatically, with three non-steroidal new molecular entities, each with completely different mechanisms of action, receiving FDA approval in the past year. As a three-part series, each non-steroidal molecule will be reviewed. We focus first on topical ruxolitinib, which received FDA approval in September of 2021 as the first Janus Kinase Inhibitor (JAK) for the treatment of atopic dermatitis. Other topical therapies covered in this review series include tapinarof, an aryl hydrocarbon receptor modulating agent, which was approved for the treatment of psoriasis in May 2022 and topical roflumilast, a highly potent phosphodiesterase-4 inhibitor, which was recently approved in July 2022 for treatment of plaque psoriasis. In addition to their unique mechanisms of action and spectra of activity, each of these agents have unique clinical characteristics - including degree of efficacy, rapidity of onset of efficacy, potential remittive effects, and safety and tolerability profiles. In this review series, we review and summarize the data surrounding each agent, providing a comprehensive overview which will allow dermatology providers to confidently and appropriately integrate them into treatment paradigms. As stated, this contribution focuses on topical ruxolitinib, the only topical JAK therapy FDA approved for treatment atopic dermatitis, and most recently, the first ever approved therapy for nonsegmental vitiligo.

A 1-year-old girl presented with porcelain white fingernails, accidentally discovered when she was referred for an infantile hemangioma consultation. The family reported that the nails had been milky white since birth and her father had similar white finger and toenails. The father remembered that additional family members on his side of the family presented with white nails; however, he could not provide exact information about the number of other relatives affected by this nail abnormality. The girl and her father were the only available family members with white nails presented for this study (Figure 1). The girl presented with leukonychia totalis on all fingernails only, while the father had this abnormality on all finger and toenails (Figure 2). We were not aware of any association with other diseases or features in this family, except hemangioma in the girl. (SKINmed. 2023;21:44-46).

A 13-year-old Hispanic boy with no significant medical etymology presented with a chief complaint of widespread brown macules and patches. He had a large and evenly pigmented brown patch, with a centrally located 2.2 cm × 1.2 cm soft and darkly pigmented plaque, which became more apparent with tension applied to the surrounding skin (Figure 1). The patient's mother stated that the plaque was present since birth and had increased in size over time. The clinical differential diagnoses included a congenital melanocytic nevus (CMN), a large café au lait macule (CALM), and a Becker's nevus with a congenital smooth muscle hamartoma.

An 11-year-old boy presented with serial autoamputations of the right 4th and 5th toes during the past 6 years. This was associated with sensory loss on the right leg and development of constriction bands around the right 2nd and 3rd digits for the past 5 months. For a year, the patient had been treated with paucibacillary, multi-drug therapy (PB-MDT) with a presumptive diagnosis of leprosy. He was born from a nonconsanguinous marriage and the birth was uneventful. The developmental milestones were normal, and no family history of any congenital anomalies was reported.