Acta dermato-venereologica最新文献

Various scoring systems for atopic dermatitis assess different aspects of the disease, but the supporting data on their validation and reliability are often limited. To ensure accurate interpretations, it is essential to conduct thorough reliability and agreement testing. This study aimed to evaluate the reliability and reproducibility of 5 atopic dermatitis assessment tools - Eczema Area and Severity Index (EASI), objective Scoring Atopic Dermatitis Index (oSCORAD), validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD), Three Item Severity (TIS) score, and Six-Area, Six-Sign Atopic Dermatitis (SASSAD) severity score - among trained dermatology residents. Thirteen patients were assessed twice by 11 raters using each scoring system. Intrarater and interrater reliability were evaluated. EASI demonstrated the highest interrater reliability (ICC = 0.768 and 0.796); SASSAD and oSCORAD followed closely (ICC = 0.741 and 0.772; ICC = 0.723 and 0.709, respectively). The TIS (ICC=0.553 and 0.584) and IGA (Kendall's W=0.273 and 0.315) exhibited the lowest reliability. Given the generally higher reliability in this study compared with previous research, implementing standardized training on atopic dermatitis scoring systems early in the education of resident physicians may improve the reliability of these tools, equipping future dermatologists to perform effectively in clinical trials and drug programmes.

The increasing use of JAK inhibitors in clinical practice is raising concerns regarding the potential risk of cutaneous lymphoma. This study aimed to conduct a comprehensive search for cases of cutaneous lymphoma associated with JAK inhibitors in the Food and Drug Administration's Adverse Event Reporting System. The clinical characteristics of cases from January 2004 to September 2023 were retrieved from the FAERS database. Disproportionality and Bayesian analyses were performed to detect signals for cutaneous lymphoma associated with JAK inhibitors. In total, 24 cases of cutaneous lymphoma were identified associated with JAK inhibitors, including tofacitinib, ruxolitinib, baricitinib, upadacitinib, and abrocitinib. The majority of patients (64%) were aged 60 or older, with no significant difference in incidence between genders. The average onset time was 8.64 months. One patient with ruxolitinib experienced a fatal outcome, and 1 patient with tofacitinib had a life-threatening event. Cutaneous lymphoma associated with baricitinib has the highest reporting odds ratio (23.91, 95% confidence interval 10.71-53.4), proportional reporting ratio (23.88, χ2 = 103.67), information component (4.57, IC025 = 2.05), and empirical Bayes geometric mean (23.73, EBGM05 = 12.12). The occurrence of cutaneous lymphoma associated with JAK inhibitors highlights the importance of pharmacovigilance studies to deepen our understanding of both the medications and associated conditions.

Hypopigmented mycosis fungoides is a rare variant of mycosis fungoides often seen in younger patients and individuals with darker skin tones and is characterized by hypopigmented patches or plaques. The lesions are usually asymptomatic and respond well to topical treat-ment or phototherapy. This article presents a case of an adult Caucasian male with a rare variant of CD8-negativeh hypopigmented mycosis fungoides, with a rapid progression to erythrodermic lesions, failure of standard treatment, and a good response to mogamulizumab.

Cutaneous squamous cell carcinoma (cSCC) is a common skin malignancy characterized by aggressive growth and metabolic reprogramming. Alpha-enolase (ENO1), a key glycolytic enzyme that is frequently over-expressed in cancer, has not been thoroughly investigated in cSCC, particularly with regard to how it coordinates glycolysis and oxidative phosphorylation (OXPHOS). ENO1 expression was interrogated in Gene Expression Omnibus datasets and validated in cSCC patient specimens. ENO1 was silenced in cSCC cell lines, and the resulting effects on cell viability, migration, invasion, apoptosis, and reactive oxygen species (ROS) levels were quantified. The impact of ENO1 knockdown on tumour growth was assessed in a xenograft model. Metabolic flux was analysed with Seahorse XFe96 extracellular-flux assays. ENO1 was significantly elevated in cSCC relative to normal skin and correlated positively with proliferative and invasive markers, but negatively with apoptosis markers. ENO1 silencing curtailed cell viability, migration, and invasion, while inducing apoptosis. Additionally, tumour growth was significantly impaired in vivo. Seahorse analysis showed that ENO1 knockdown suppressed glycolysis and redirected metabolic flux toward OXPHOS. Consistent with this shift, intracellular ROS increased and partially suppressed cell viability by modulating the ROS-sensitive Akt/mTOR pathway. In conclusion, ENO1 knockdown compromises tumorigenicity and promotes OXPHOS. Combining ENO1 inhibition with oxidative-stress-enhancing treatments, such as chemotherapy or radiotherapy, may further enhance efficacy.

There is a paucity of data regarding the use of Janus kinase inhibitors in elderly patients with moderate-to-severe atopic dermatitis necessitating systemic therapy. This study aimed to evaluate the efficacy and safety of abrocitinib compared with dupilumab in atopic dermatitis patients aged 60 years or older. A single-centre, non-randomized controlled trial (ChiCTR2300077724) was conducted from December 2022 to March 2024, in which 58 patients were assigned to receive either abrocitinib (100 mg daily) or dupilumab (600 mg loading dose followed by 300 mg every 2 weeks). The primary endpoints were the proportion of patients achieving a ≥ 4-point reduction in the Peak Pruritus Numerical Rating Scale (PP-NRS) at Week 2 and the proportion achieving Eczema Area and Severity Index (EASI)-75 at Week 12; EASI-90 response at Week 24 was a key secondary endpoint. Results showed that a higher proportion of patients receiving abrocitinib achieved a PP-NRS4 response at Week 2 (52% vs 26%; p = 0.046). At Week 12, EASI-75 response rates were similar between the 2 groups (45% for abrocitinib vs 44% for dupilumab; p = 0.95). By Week 24, the EASI-90 response rate was 52% in the abrocitinib group compared with 41% in the dupilumab group (p = 0.4). Adverse events in the abrocitinib group included colon tumour (3%), nausea (6%), folliculitis (6%), and headache (16%), while the dupilumab group reported T-cell prolymphocytic leukaemia (3%) and conjunctivitis (7%). In conclusion, abrocitinib provided more rapid relief from pruritus and demonstrated superior long-term efficacy compared with dupilumab in the elderly population.