Journal of Clinical and Aesthetic Dermatology最新文献

Cross-specialty collaboration can be helpful in the treatment of patients with complex medical conditions involving dermatologic manifestations. This article underscores the utility of multidisciplinary collaboration through discussion of seven hypothetical case scenarios, including patient care in the clinical contexts of hidradenitis suppurativa, venous varicosities, scleroderma, gender-affirming care, sequelae from cancer, solid organ transplantation, and neurocutaneous syndromes. Through these cases, we highlight how a holistic healthcare approach that encompasses multiple specialties can positively contribute to dermatologic patient care.

Objective: The rapid expansion of the internet, specifically social media, has reshaped how patients approach their health and obtain their medical information. Specifically, Reddit communities have become important spaces for patients with psoriasis to engage in discussions, particularly regarding the newly United States Food and Drug Administration-approved medication, risankizumab. The objective of this study was to analyze questions from patients with psoriasis about risankizumab on Reddit.

Methods: The authors analyzed all risankizumab-related questions posted on the r/Psoriasis and r/Skyrizi subreddits. Questions were categorized and subcategorized for analysis.

Results: A total of 222 questions from 181 posts were analyzed. The largest proportion of questions were regarding side effects (26.1%) and cost and insurance (14.9%). This analysis of risankizumab questions on Reddit reveals key insights into the informational needs of patients with psoriasis and demonstrates the value of utilizing online platforms to better understand patient concerns.

Limitations: One limitation of this study is that Reddit users may not be representative of the overall psoriasis population.

Conclusion: The study presents a distinct approach by harnessing the power of social media data to understand patient perspectives, which may not be readily apparent in clinical settings. This information may help physicians improve the overall patient experience and provide more tailored clinical care.

Considering the rapid pace of developments in the field of cancer immunotherapy, continuous updates on the topic are critical for the medical community. With incidences of cutaneous malignancies on the rise, it is more imperative than ever to utilize and understand current and future treatment modalities. Currently, the United States (US) Food and Drug Administration (FDA) approval for various immune checkpoint inhibitors (ICIs), particularly programmed cell death protein 1 (PD-1) inhibitors, in an adjuvant setting for various cutaneous malignancies is the mainstay in treatment of a number of cutaneous malignancies. Given the transformative potential of PD-1 inhibitors within the realm of immunotherapy, an understanding of the current state of research in this area is essential for dermatologists. This is important because in the cutaneous oncological world, neoadjuvant therapy is quickly demonstrating to show significant importance skin cancer treatment. Traditional neoadjuvant therapy involves a combination of chemotherapy, radiation, and/or targeted therapy, depending on the type and stage of malignancy. The main objective in these therapies has been to reduce tumor size for improved operability, manage systemic disease, and treat operable tumors prior to surgical intervention to obtain a more favorable long-term survivability. This review aims to provide a succinct analysis of both recent and current research of PD-1 inhibitors in the neoadjuvant setting of melanoma, squamous cell carcinoma, and merkel cell carcinoma.

Atopic dermatitis (AD) commonly presents in both children and adults with pruritic, eczematous lesions that can have a substantial impact on quality of life. Current biologics approved for AD include dupilumab, an IL-4 receptor alpha inhibitor, tralokinumab, an IL-13 inhibitor, lebrikizumab, an IL-13 inhibitor, and nemolizumab, an IL-31 receptor alpha inhibitor. Dupilumab, tralokinumab, and lebrikizumab are highly effective in addressing the inflammatory response and reducing pruritus in AD patients via the IL-13 pathway, but are also associated with conjunctivitis and ocular surface disorders (OSD) in some patients, especially compared to other biologics that do not inhibit the activity of IL-4 and/or IL-13. For practitioners, it is important to be aware that OSD is a relatively common side effect but rarely causes problems severe enough to lead to cessation of treatment. This brief report provides guidance on screening and managment of OSD in patients with AD receiving anti-IL-4 and/or IL-13 treatment.

Atopic dermatitis (AD) is a chronic inflammatory skin condition that often requires systemic treatment to achieve optimal clinical outcomes. The clinical and immunological heterogeneity of AD necessitates the use of various therapies to maximize efficacy while minimizing adverse events (AEs). Dupilumab, the first biologic agent approved by the United States Food and Drug Administration (FDA) for moderate-to-severe AD, targets interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling pathways. Although effective, some patients experience dupilumab-associated musculoskeletal AEs, such as arthralgia, arthritis, or enthesitis, which may lead to discontinuation of treatment. Recent studies suggest that IL-4 inhibition disrupts T-cell populations, promoting a skewed T-helper 17 (Th17)-dominant immune response that may contribute to arthralgia. Switching to alternative therapies, such as tralokinumab-an IL-13-specific inhibitor-has shown promise in alleviating these AEs while maintaining control of AD signs and symptoms. Case reports indicate that patients with dupilumab-associated arthralgia have improved after switching to tralokinumab, suggesting the potential of tralokinumab as a safer alternative for these individuals. We present a series of 15 AD patients treated with tralokinumab following discontinuation of dupilumab due to arthralgia. All 15 patients achieved clear or nearly clear skin and demonstrated reductions in AD signs and symptoms as measured by Investigator's Global Assessment (IGA), body surface area of involvement (BSA), and/or patient reported measures of pruritus. Importantly, all patients experienced resolution of arthralgia without recurrence while on tralokinumab. These findings support the use of tralokinumab as an effective and safe alternative therapy for patients with dupilumab-induced arthralgia.