JAAD International最新文献

英文中文

Impact of disease cyclicity on quality-of-life impairment—A mixed method explanatory study

JAAD International

Pub Date : 2025-02-01 DOI: 10.1016/j.jdin.2024.09.007

Ying Shan Cheung MD , Winston Tham Zhi Wen , Ashvin R. Chundayil , Phillip Phan PhD , Ellie Choi Ci-En MBBS, MRCP

Background

Disease cyclicity, a composite measure of unpredictable and daily fluctuations of symptoms, strongly predicts quality-of-life (QoL) impairment.

Objective

To explore the mechanisms by which cyclicity impacts QoL.

Methods

1:1 semi-structured interviews were conducted and qualitatively analyzed using grounded theory. Common themes were identified and used to derive a theoretical framework.

Results

Twenty-three adults, (median age 28.5, range 20-72) with a range of chronic inflammatory diseases including eczema, psoriasis, and inflammatory arthritis were prospectively recruited. Cyclicity, characterized by unpredictability, uncontrollability, and lability, contributed to a varying productivity and inconsistent ability in performing daily activities. Challenges intensified if external expectations of the patient were inconsistent with their fluctuating ability. Coping abilities, shaped by internal and external factors, moderated the relationship between cyclicity and QoL impairment.

Limitations

Qualitative interviews assume patients have accurate insights into their own behaviors. The generalizability of findings may be limited in other populations.

Conclusion

Disease cyclicity defines many inflammatory diseases. This study provides a theoretical framework for understanding and managing the challenges patients with a cyclical condition face.

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引用次数: 0

Risk of infections during treatment with oral Janus kinase inhibitors in randomized placebo-controlled trials: A systematic review and meta-analysis 随机安慰剂对照试验中口服Janus激酶抑制剂治疗期间感染的风险：系统回顾和荟萃分析。

JAAD International

Pub Date : 2025-02-01 DOI: 10.1016/j.jdin.2024.09.012

Daniel Isufi BSc(Med) , Mikkel Bak Jensen MD , Nikolai Loft MD, PhD , Lone Skov MD, PhD, DMSc , Jesper Elberling MD, PhD , Farzad Alinaghi MD, PhD

Janus kinase (JAK) inhibitors block pathways involved in inflammation and immune response, making JAK inhibitors useful in the treatment of various diseases. While the efficacy of these drugs has been proven in several studies, their safety profile needs to be further investigated. In this systematic review and meta-analysis, we examined the risk of infections during treatment with oral JAK inhibitors with no concomitant treatment compared to placebo in phase 2 and 3 randomized, placebo-controlled trials. The medical databases PubMed, Web of Science, and EMBASE were searched from inception through February 2024, yielding 13,567 nonduplicate articles, of which 69 were included in the final quantitative analysis. Overall, we found that treatment with oral JAK inhibitors was associated with an increased risk of infections compared to placebo across all indications (relative risk: 1.39 [95% CI: 1.096-1.76, P = .0067]) and in dermatologic indications (relative risk: 1.46 [95% CI, 1.10-1.93, P = .0097]). Remarkably, an increased risk of herpes zoster infections was found in dermatologic indications but not in nondermatologic indications. In conclusion, we identified a significantly increased risk of developing infections during treatment with oral JAK inhibitors compared to placebo across indications. In sub-analyses, we additionally found an increased risk of herpes zoster in dermatologic indications.

Janus激酶（JAK）抑制剂阻断炎症和免疫反应的通路，使JAK抑制剂在治疗各种疾病中有用。虽然这些药物的有效性已在几项研究中得到证实，但其安全性需要进一步调查。在这项系统综述和荟萃分析中，我们在2期和3期随机、安慰剂对照试验中比较了口服JAK抑制剂治疗期间未合并治疗与安慰剂治疗期间的感染风险。从开始到2024年2月，检索了医学数据库PubMed、Web of Science和EMBASE，得到13567篇非重复文章，其中69篇被纳入最终的定量分析。总的来说，我们发现口服JAK抑制剂治疗与安慰剂相比，在所有适应症（相对危险度：1.39 [95% CI: 1.096-1.76, P = 0.0067]）和皮肤病适应症（相对危险度：1.46 [95% CI, 1.10-1.93, P = 0.0097]）中感染风险增加。值得注意的是，带状疱疹感染的风险增加是在皮肤指征中发现的，而不是在非皮肤指征中。总之，我们发现口服JAK抑制剂治疗期间发生感染的风险显著增加，与安慰剂的适应症相比。在亚分析中，我们还发现皮肤指征中带状疱疹的风险增加。

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引用次数: 0

Evaluating the appropriateness of skin cancer prevention recommendations obtained from an online chat-based artificial intelligence model 评估从基于在线聊天的人工智能模型获得的皮肤癌预防建议的适当性。

JAAD International

Pub Date : 2025-02-01 DOI: 10.1016/j.jdin.2024.07.028

Elise M. Cai BS, Pirunthan Pathmarajah MD, Roxana Daneshjou MD, PhD, Justin M. Ko MD, MBA, Albert S. Chiou MD, MBA

引用次数: 0

NRAS tumor mutations are associated with reduced odds of dermatologic adverse events in patients with metastatic melanoma receiving immune checkpoint inhibitors 在接受免疫检查点抑制剂治疗的转移性黑色素瘤患者中，NRAS肿瘤突变与皮肤不良事件发生率降低相关。

JAAD International

Pub Date : 2025-02-01 DOI: 10.1016/j.jdin.2024.11.004

Michael S. Chang MD , Jordan T. Said MD , Elliot H. Akama-Garren PhD , Nicole Trepanowski MD , Ai-Tram N. Bui MD , Anita Giobbie-Hurder MS , Nicole R. LeBoeuf MD, MPH , Rebecca I. Hartman MD, MPH

引用次数: 0

Treatment of postburn hypertrophic scaring in skin of color with fractional CO2 laser - A prospective cohort study

JAAD International

Pub Date : 2025-01-06 DOI: 10.1016/j.jdin.2025.01.001

Samman Khalid MBBS , Bianca Sanabria MA , Isabella Tan BS , Samavia Khan MD , Husnain Khan FCPS , Babar Rao MD

Objective

To evaluate the efficacy of fractional CO2 laser therapy in treating mature hypertrophic burn scars.

Method

A prospective cohort study enrolled burn patients with postburn hypertrophic scars undergoing fractional CO2 laser treatment in Rawalpindi, Pakistan. Patients aged 12 to 80 years were included, receiving 4 laser sessions every 4-6 weeks. Demographic data and scar assessments using the Vancouver Scar Scale and Patient Observer Scar Assessment Scale were collected.

Results

Twenty-five patients with hypertrophic scars received treatment. Vancouver Scar Scale scores showed significant reductions, with improvements in scar vascularity (pre: 0.85 ± 1.085, post: 0.10 ± 0.300, P < .001), pigmentation (pre: 2.44 ± 0.673, post: 2.12 ± 0.900, P = .008), and pliability (pre: 2.29 ± 1.078, post: 1.39 ± 0.997, P < .001). Patients with Fitzpatrick skin types III and IV had notable Vancouver Scar Scale score improvements (P = .013, P < .001). Patient Observer Scar Assessment Scale scores also decreased significantly post-treatment (P < .001).

Conclusion

Fractional CO2 laser therapy shows promise in managing mature hypertrophic burn scars, with improvement in scar appearance, functionality, and symptom relief. Stratification by Fitzpatrick skin type highlights the need for further research to optimize treatment strategies, particularly in populations with darker skin tones. This study underscores the importance of further longitudinal studies on burn scars to enhance outcomes for all burn survivors.

{"title":"Treatment of postburn hypertrophic scaring in skin of color with fractional CO2 laser - A prospective cohort study","authors":"Samman Khalid MBBS , Bianca Sanabria MA , Isabella Tan BS , Samavia Khan MD , Husnain Khan FCPS , Babar Rao MD","doi":"10.1016/j.jdin.2025.01.001","DOIUrl":"10.1016/j.jdin.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of fractional CO2 laser therapy in treating mature hypertrophic burn scars.</div></div><div><h3>Method</h3><div>A prospective cohort study enrolled burn patients with postburn hypertrophic scars undergoing fractional CO2 laser treatment in Rawalpindi, Pakistan. Patients aged 12 to 80 years were included, receiving 4 laser sessions every 4-6 weeks. Demographic data and scar assessments using the Vancouver Scar Scale and Patient Observer Scar Assessment Scale were collected.</div></div><div><h3>Results</h3><div>Twenty-five patients with hypertrophic scars received treatment. Vancouver Scar Scale scores showed significant reductions, with improvements in scar vascularity (pre: 0.85 ± 1.085, post: 0.10 ± 0.300, <em>P</em> < .001), pigmentation (pre: 2.44 ± 0.673, post: 2.12 ± 0.900, <em>P</em> = .008), and pliability (pre: 2.29 ± 1.078, post: 1.39 ± 0.997, <em>P</em> < .001). Patients with Fitzpatrick skin types III and IV had notable Vancouver Scar Scale score improvements (<em>P</em> = .013, <em>P</em> < .001). Patient Observer Scar Assessment Scale scores also decreased significantly post-treatment (<em>P</em> < .001).</div></div><div><h3>Conclusion</h3><div>Fractional CO2 laser therapy shows promise in managing mature hypertrophic burn scars, with improvement in scar appearance, functionality, and symptom relief. Stratification by Fitzpatrick skin type highlights the need for further research to optimize treatment strategies, particularly in populations with darker skin tones. This study underscores the importance of further longitudinal studies on burn scars to enhance outcomes for all burn survivors.</div></div>","PeriodicalId":34410,"journal":{"name":"JAAD International","volume":"19 ","pages":"Pages 35-42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and histopathologic characteristics and outcomes of cellular dermatofibroma: A retrospective observational study of 29 patients

JAAD International

Pub Date : 2025-01-06 DOI: 10.1016/j.jdin.2024.12.001

Nicholas T. Le BS , Daniel B. Eisen MD

引用次数: 0

Histologic absence of yeast as a clue for classic lichen planopilaris, fibrosing alopecia in a pattern distribution, and frontal fibrosing alopecia: A cross-sectional observational study

JAAD International

Pub Date : 2024-12-19 DOI: 10.1016/j.jdin.2024.11.008

Kimberly Williams BS , Antonella Tosti MD , Curtis T. Thompson MD

引用次数: 0

Weight gain secondary to the use of oral Janus kinase inhibitors: A systematic review and meta-analysis

JAAD International

Pub Date : 2024-12-19 DOI: 10.1016/j.jdin.2024.11.009

Grace Xiong BHSc , Eric Yu , Martin Heung , Jaehyeong Yang BSc , Megan Lowe MPH , Mohannad Abu-Hilal MD

Oral Janus kinase inhibitors (JAKi) are increasingly used in dermatology, rheumatology, gastroenterology, and hematology. While effective, they can cause adverse effects such as acne, nausea, cytopenia, dyslipidemia, and Herpes zoster. Recent reports have linked JAKi usage to weight changes, particularly weight gain, which can significantly impact patients' quality of life. This study aimed to describe the incidence and characteristics of weight changes associated with the use of JAKi. Ovid MEDLINE, Embase, Web of Science, and Clinicaltrials.gov were searched up to April 2024. From 1080 initial articles, 90 studies covering 16,000 patients were selected. Our analysis found a notable incidence of weight gain with JAKi usage. Overall, 5.9% (947/16,000) of patients reported weight again. In randomized control trials, weight gain was observed in 7% (95% CI: 0.04; 0.09) of patients, while weight loss was observed in 1% (95% CI: 0.00; 0.03). Patients with dermatologic indications had lower weight gain rates (4%, 95% CI: 0.01; 0.06) than those with nondermatological indications (7%, 95% CI: 0.04; 0.10). Overall, JAKi therapy is associated with weight changes, particularly weight gain, underscoring the importance of appropriate counseling and weight monitoring. Further long-term studies are needed to better understand the mechanisms and management of JAKi-related weight changes.

口服 Janus 激酶抑制剂（JAKi）越来越多地用于皮肤病学、风湿病学、胃肠病学和血液病学。这些药物虽然有效，但也会引起痤疮、恶心、细胞减少、血脂异常和带状疱疹等不良反应。最近有报道称，JAKi 的使用与体重变化有关，尤其是体重增加，这会严重影响患者的生活质量。本研究旨在描述与使用 JAKi 相关的体重变化的发生率和特征。研究人员检索了截至 2024 年 4 月的 Ovid MEDLINE、Embase、Web of Science 和 Clinicaltrials.gov。从最初的1080篇文章中筛选出了90项研究，涉及16000名患者。我们的分析发现，使用JAKi后体重增加的发生率很高。总体而言，5.9%（947/16,000）的患者报告体重增加。在随机对照试验中，7%的患者体重增加（95% CI：0.04；0.09），1%的患者体重减轻（95% CI：0.00；0.03）。皮肤病适应症患者的体重增加率（4%，95% CI：0.01；0.06）低于非皮肤病适应症患者（7%，95% CI：0.04；0.10）。总体而言，JAKi疗法与体重变化有关，尤其是体重增加，这强调了适当咨询和体重监测的重要性。需要进一步开展长期研究，以更好地了解与JAKi相关的体重变化的机制和管理方法。

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引用次数: 0

Cutaneous complications to medical adhesives in left ventricular assist device patients: A retrospective cohort study

JAAD International

Pub Date : 2024-12-16 DOI: 10.1016/j.jdin.2024.11.007

Brenda Umenita Akinniyi MS , Hala Rogers MD , Shawn Glocker BS , Farooq H. Sheikh MD , Michael A. Cardis MD

引用次数: 0

Atopic dermatitis in childhood and pubertal development: A nationwide cohort study

JAAD International

Pub Date : 2024-11-21 DOI: 10.1016/j.jdin.2024.09.018

Camilla Lomholt Kjersgaard MD , Andreas Ernst MD, PhD , Pernille Jul Clemmensen MD, PhD , Lea Lykke Harrits Lunddorf MD, PhD , Linn Håkonsen Arendt MD, PhD , Nis Brix MD, PhD , Onyebuchi A. Arah MD, PhD , Mette Deleuran MD, PhD , Cecilia Høst Ramlau-Hansen MHSc, PhD

Background

Atopic dermatitis (AD) might delay puberty, but research is lacking.

Objective

To investigate the association between AD and puberty.

Methods

A subcohort within the Danish National Birth Cohort includes children born between 2000 and 2003, with mothers reporting doctor-diagnosed AD at 6 months, 18 months, and 7 years old. The National Patient Registry identified hospital-diagnosed AD. From 11 years, the children give half-yearly information on pubertal development. We estimated the mean age difference in months at attaining Tanner stages 1 to 5 and the development of axillary hair, acne, first ejaculation, voice break, and age at menarche, using an interval-censored regression model.

Results

In total, 15,534 children participated, 21.5% had self-reported doctor-diagnosed AD and 0.7% had hospital-diagnosed AD. For girls with self-reported doctor-diagnosed AD, the average age difference at reaching all pubertal milestones was 0.0 months (95% confidence interval [CI]: −0.8; 0.8), and for hospital-diagnosed AD, it was −0.3 months (95% CI: −5.4; 4.8). For boys, the average age difference was 0.1 months (95% CI: −0.6; 0.9) and −0.3 months (95% CI: −3.6; 3.0), respectively.

Limitations

No information on treatment was available. Missing data on covariates (<5%) were not addressed.

Conclusion

No association was found between AD and puberty in either girls or boys.

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引用次数: 0

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