Acta dermato-venereologica最新文献

Perioperative immune-checkpoint inhibition (ICI) using pembrolizumab (3 doses of pembrolizumab 200 mg every 3 weeks before surgery and 15 doses afterwards) in advanced resectable melanoma has shown substantial pathological response rates and improved event-free survival (EFS) compared to postoperative (adjuvant) ICI. Real-world evidence on efficacy and safety of perioperative ICI in melanoma remains limited. In this retrospective single-centre study, 20 patients with resectable stage IIIB–IV melanoma were treated with perioperative pembrolizumab. Radiological and pathological responses, early survival outcomes and treatment-related adverse events were analysed at a median follow-up of 13.9 months. Eighteen patients (18/20) underwent surgery. A pathological complete response was observed in 44% (8/18), while 56% (10/18) showed a pathological non-response. No patient (0/18) had a pathological partial response. One-year EFS was 66.5% (95% confidence interval (CI) 47.3-93.3), 1-year relapse-free survival 77.6% (95% CI 57.9-100) and 1-year overall survival 89.2% (95% CI 76.0-100, identical with 1-year melanoma-specific survival). Immune-related adverse events occurred in 50% of the patients (≥grade 3 in 15%). Our study confirms the feasibility of perioperative pembrolizumab in a real-world setting and shows promising efficacy and tolerability in melanoma. Pathological response may guide surgical and adjuvant strategies.

Chronic hand eczema is a multifactorial disease that can impact quality of life considerably. This observational questionnaire study aimed to investigate real-world treatments and patients' experiences of disease burden across the broad severity spectrum represent-ed by the general chronic hand eczema population. The study included 1,948 individuals from 6 countries (mean age 43.2 years; 64.5% females) with self-reported physician-diagnosed chronic hand eczema. Ongoing treatment was reported in 68.6%, which included systemics or phototherapy (with or without topicals; 10.7%), topical corticosteroids (with or without additional topicals; 36.0%) and other topical treatments (no topical corticosteroids; 21.8%). At survey time, 43.0% were in flare state. About half, 51.1%, reported moderate to severe disease signs (past week). Treatment with topical corticosteroids was suboptimal in 9.7% of those with moderate to severe disease. Experience of symptoms was common, particularly itch. Symptom burden differed significantly between groups with different treatments and severity levels; it was highest among those reporting systemics/phototherapy and those for whom topical corticosteroids were suboptimal. The results indicate that, despite a high treatment rate, chronic hand eczema is associated with a considerable disease burden that varies significantly across the severity spectrum. A particularly high burden in treatment stages beyond topical corticosteroids indicates a need for more effective management of symptoms.

To evaluate the efficacy and safety of narrow-band ultraviolet B (NB-UVB) in treating refractory Hailey-Hailey Disease (HHD), four HHD patients (36-68 years old, disease duration 5-20 years) were included. NB-UVB was administered twice weekly, with initial doses 0.300-0.500 J/cm2; and 0.050 J/cm2; increments per session, and some patients received concurrent topical medications; follow-up lasted 1.5-3 months, with outcomes assessed via lesion body surface area (BSA) and Visual Analog Scale scores (disease severity, Refractory Visual Analog Scale, pruritus). Onset time was 0.25-4 months: 2 patients achieved complete lesion clearance, the other 2 had 60% and 87.5% BSA reduction, and the longest remission was 18 months; only 1 patient reported moderate irradiation-site pain, with no severe adverse events. NB-UVB shows satisfactory efficacy and good safety in refractory HHD and may serve as a viable treatment option.

Hand eczema is the most common occupational skin disease (OSD), often leading to sick leave or job termination. Standard diagnostic procedures are often ambiguous. Molecular classification has been described to improve differentiation between eczema and psoriasis, which is the most common differential diagnosis. Since 2020, a cohort of 287 patients with suspected, occupational hand and/or foot dermatoses (eczema or psoriasis) has been established in Germany. The current analysis focuses on descriptive results on the days of absence from work, occupational retention and legal recognition of OSD after 24 months. A total of 38.9% of the patients did not receive a distinct clinical diagnosis, while molecular diagnostics provided results in 93.1% of these cases. Sick leave days significantly decreased over 2 years (p<0.005) from a mean of 28.7 to 8.2 days. Legal recognition of OSD tripled from 10.1% to 30.2%. Job terminations due to skin diseases reached 27.1%, primarily from job changes or unemployment. Molecular diagnostics enhance diagnostic precision and may support improved prevention and disease management, reducing sick leave. The findings underscore the individual severity and social impact of skin diseases like eczema and psoriasis in high-risk employments.